| Chorioamniotic membrane separation: a potentially lethal finding. | |
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MedLine Citation:
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PMID: 9218946 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Sonographic detection of chorioamniotic membrane separation (CMS) has been considered a benign incidental finding. We now report 6 cases of CMS identified by prenatal ultrasound; 1 in an otherwise normal pregnancy and 5 following fetal surgery. Following membrane separation, amniotic bands formed and compromised the umbilical cord in 4 cases leading to 2 fetal deaths. In the first case, CMS was detected by ultrasound at 22 weeks' gestation in an otherwise uncomplicated pregnancy. Because CMS was considered benign and umbilical cord blood flow was ample, the mother was followed by intermittent sonographic examinations. Fetal demise occurred 2 weeks later, clearly due to umbilical cord strangulation by an amniotic band. Surprised by this unexpected outcome, we reviewed our experience with CMS after hysterotomy for fetal surgery. Out of more than 40 fetal surgical cases, we have 5 cases in which CMS was recognized after hysterotomy. Three of these fetuses had umbilical cord compromise by a band of amniotic membrane leading to 1 fetal death. This experience demonstrates that membrane separation may be associated with amniotic band formation which can lead to cord strangulation and fetal compromise. Following fetal surgery, serial ultrasound evaluation and close fetal monitoring are indicated. In otherwise unremarkable pregnancies, clinician awareness of the possibility of amniotic band formation following CMS should be heightened. In either situation, knowledge of this potential life-threatening complication may identify cases in which cord compromise requires emergent delivery or fetoscopic release of the strangulating amniotic band. |
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Authors:
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J L Graf; J F Bealer; D L Gibbs; N S Adzick; M R Harrison |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Fetal diagnosis and therapy Volume: 12 ISSN: 1015-3837 ISO Abbreviation: Fetal. Diagn. Ther. Publication Date: 1997 Mar-Apr |
Date Detail:
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Created Date: 1997-10-08 Completed Date: 1997-10-08 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9107463 Medline TA: Fetal Diagn Ther Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 81-4 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of California, San Francisco, USA. jgraf@itsa.ucsf.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amnion / abnormalities, pathology, ultrasonography Amniotic Band Syndrome / diagnosis*, embryology, surgery Chorion / abnormalities Extraembryonic Membranes / abnormalities*, pathology, ultrasonography Female Fetal Death Humans Infant, Newborn Postoperative Complications Pregnancy Pregnancy Complications / diagnosis*, surgery Pregnancy Outcome Ultrasonography, Prenatal Umbilical Cord / pathology Uterus |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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