title: Limb constriction secondary to pseudoamniotic band syndrome after selective fetoscopic laser surgery: report of a case with a favorable outcome.
abstract: Pseudoamniotic band syndrome (PABS) is an iatrogenic complication that causes entanglement of fetal parts in a constrictive sheet of detached or ruptured amniotic membrane after an invasive procedure, namely amniocentesis, amnioreduction or septostomy in twins. The incidence and risk factors for PABS after fetoscopy-guided laser have not been documented [Winer et al.: Am J Obstet Gynecol 2008;198:393.e1-393.e5]. We report a case of monochorionic biamniotic twin pregnancy submitted to selective fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome at 16 weeks of gestation. The procedure was complicated by the death of one of the fetuses at 24 weeks of gestation. Moreover, the surviving twin was diagnosed postnatally with pseudoamniotic band syndrome, presenting with affected limbs. The newborn was submitted to surgical correction of these lesions with a successful outcome and was discharged on day 15.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital de Santa Maria, Lisbon, Portugal. andreia.dalmeida@gmail.com
authors.forename: Andreia
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Cláudia
authors.initials: C
authors.lastname: Araújo
authors.forename: Rui
authors.initials: R
authors.lastname: Carvalho
authors.forename: Maria Antonieta
authors.initials: MA
authors.lastname: Melo
authors.forename: Luísa
authors.initials: L
authors.lastname: Pinto
authors.forename: Luís Mendes
authors.initials: LM
authors.lastname: da Graça
mesh_terms: D000328:Adult; D000652:Amniotic Band Syndrome / Q000209:etiology* / Q000503:physiopathology; D002585:Cesarean Section; D003250:Constriction; D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000196:embryology / Q000601:surgery*; D005332:Fetoscopy / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D053685:Laser Therapy / Q000009:adverse effects; D008028:Light Coagulation / Q000009:adverse effects; D017880:Limb Deformities, Congenital / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011247:Pregnancy; D059285:Pregnancy, Twin; D047929:Term Birth; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal