title: In utero limb salvage: fetoscopic release of amniotic bands for threatened limb amputation.
abstract: The natural history of extremity amniotic band syndrome (ABS) is a progression to deformity or amputation. Fetoscopic laser release of amniotic bands in extremity ABS offers the potential to prevent limb amputation. The authors report on 2 patients with isolated extremity ABS who underwent fetoscopic release. Both patients had isolated extremity ABS with compromised extremity perfusion and no other significant structural abnormality diagnosed sonographically. The first patient underwent fetoscopic release of bands of the left wrist, and the second patient underwent lysis of bands around the right wrist and an unsuspected band around the right lower extremity. Both patients had restoration of blood flow by color Doppler to the affected extremity. There were no perioperative complications. In select patients with isolated extremity ABS, early fetoscopic release may prevent amputation and allow improved limb development.
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Sundeep G
authors.initials: SG
authors.lastname: Keswani
authors.forename: Mark P
authors.initials: MP
authors.lastname: Johnson
authors.forename: N Scott
authors.initials: NS
authors.lastname: Adzick
authors.forename: Steven
authors.initials: S
authors.lastname: Hori
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Howell
authors.forename: R Douglas
authors.initials: RD
authors.lastname: Wilson
authors.forename: Holly
authors.initials: H
authors.lastname: Hedrick
authors.forename: Alan W
authors.initials: AW
authors.lastname: Flake
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Crombleholme
mesh_terms: D000328:Adult; D000368:Aged; D000652:Amniotic Band Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D000671:Amputation, Surgical; D005260:Female; D005332:Fetoscopy / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D023821:Limb Salvage / Q000379:methods*; D011247:Pregnancy; D014463:Ultrasonography; D014599:Uterus / Q000601:surgery*; D014953:Wrist / Q000002:abnormalities / Q000098:blood supply / Q000601:surgery