Early sonographic diagnosis of amniotic band syndrome at 11-14 weeks′ gestation

Objective To investigate the prenatal sonographic feature in the early diagnosis of amniotic band syndrome at 11-14 weeks′ gestation. Methods A retrospective study was conducted to analysis and summarize the ultrasonographic features of 4 fetuses without band-like echoes in amniotic cavity at 11-14 weeks′ gestation, but verified as amniotic band syndrome in Peking Union Medical College Hospital. Results Two cases (cases 1, 2) showed the fixed head position with skull defect and intracranial structure disorders. Cases 3 and 4 showed one upper limb in a fixed position, and the hand seemed to adhere to the umbilical cord isolatedly. In addition, case 1 showed complete chorioamniotic membrane separation. There were multiple band-like echoes adhered to body of 3 fetals during the follow-up scan at 14-18 weeks. The parents of cases 1 and 2 chose to terminate the pregnancy after counseling, the other 2 cases also induced labor due to intrauterine fetal death at 15+ 2 weeks and 19+ 2 weeks respectively. All 4 cases were confirmed as amniotic band syndrome by pathology. Conclusions When the fetal sonographic images showed fixed head position, disordered intracranial structure, or adhesion between umbilical cord and hand with limited movement at 11-14 weeks′ gestation, it should be paid attention to observing the band-like echoes and followed up closely to prevent missed diagnosis of amniotic band syndrome. Key words: Ultrasonography, prenatal; Amniotic band syndrome; Pregnancy trimester first; Adhesion of umbilical cord and hand; Chorioamniotic membrane separation