Tuğba ENSARİ ALTUN, Nuri DANIŞMAN, Salim ERKAYA, Dilek UYGUR, Ayşe SEVAL, Özgü ERDİNÇ, Ayşe KIRBAŞ

A Severe Case of Amniotic Band Syndrome Presented by Abruptio Placenta

Amniyotik bant sendromu, literatürde birçok farklı başlıklar altında anılan, geniş spektrumda konjenital anomali- lere yol açabilen, nadir bir durumdur. Konstriksiyon halka sendromu bu alt gruplardan biridir ve insidansı 1/3000- 1/15000 canlı doğum arasında değişmektedir. Bu raporda preterm premature membran rüptürü ve plasenta dekol- manı ile prezente olmuş ağır bir konstriksiyon halka sendromu vakası sunulmuştur. 18 yaşında, 27 haftalık gebeliğiolan primigravid hasta membran rupture ve vajinal kanama nedeniyle acil servise başvurduğunda, fetal bradikardinedeniyle uygulanan sezaryende fetal abdomeni çepeçevre saran konstrüksiyon halkası izlendi. Yenidoğan mua- yenesinde amniyotik band sendromu kaynaklı çoklu ekstremite defektleri saptandı. Amniyotik band sendromunuortaya çıkaran risk faktörleri halen tartışmalıdır. Genellikle prenatal dönemde ortaya konabilen bu sendrom ile ilgilikomplikasyon ve riskler hastaya anlatılmalıdır. Doğum sonrası, olası deformiteler ile ilgili multidisipliner yaklaşım- la çeşitli düzeyde olumlu sonuçlar bildirilmiştir.

Plasenta Dekolmanı ile Prezente Olan Ağır Amniyotik Band Sendromu Olgusu

Amniotic band syndrome takes different synonyms in the literature and refers to a wide spectrum of congenitalanomalies. Constriction ring syndrome is one of these subgroups and the incidence varies from 1 in 3,000 to 1 in15,000 live births. Here, we report a severe case of constriction ring syndrome presented by preterm premature rup- ture of membranes and placental abruption. An 18 years old, 27 weeks pregnant, primigravid patient admitted toemergency clinic with preterm premature rupture of membranes and vaginal bleeding. During the emergency cesar- ean section, which was performed for fetal bradycardia, a constriction ring surrounding fetal abdomen was detected.Examination of the newborn revealed multiple extremity defects originating from amniotic bands. The risk factorscausing amniyotic band syndrome are still not clear. As the syndrome is usually diagnosed at the prenatal period;the complications and the possible risks should be discussed with the patient. Postnatal surgical management of thepossible deformities is reported of favorable outcome by a multidisciplinary approach.

PDF

___

1. Chatzigeorgiou K, Theodoridis T, Efstratiou I,et al. Strangulation of the umbilical cord by an amnion band - a rare cause of intrauter- ine demise: a case report. Cases J 2009;2:9108. 2. Larciprete G, Montagnoli C, Fusco P. Severe fetal distress and um- bilical cord strangulation. Case Rep Med 2011;2011:645487. 3. Bronshtein M, Zimmer EZ. Do amniotic bands amputate fetal or- gans? Ultrasound Obstet Gynecol 1997;10:309-311. 4. Sentilhes L, Verspyck E, Eurin D, et al. Favourable outcome of a tight constriction band secondary to amniotic band syndrome. Prenat Diagn 2004;24:198-201. 5. Pedersen TK, Thomsen SG. Spontaneous resolution of amniotic bands. Ultrasound Obstet Gynecol 2001;18:673-674. 6. Torpin R. Amniochorionic Mesoblastic Fibrous Strings and Amni- onic Bands: Associated Constricting Fetal Malformations or Fetal Death. Am J Obstet Gynecol 1965;91:65-75. 7. Streeter GL. Focal deficiencies in fetal tissues and their relation to in- tra-uterine amputation. Contrib Embryol Carnegie Inst 1930;22:1-44. 8. Lockwood C, Ghidini A, Romero R, et al. Amniotic band syn- drome: reevaluation of its pathogenesis. Am J Obstet Gynecol 1989;160:1030-1033. 9. Bower C, Norwood F, Knowles S, et al. Amniotic band syndrome: a population-based study in two Australian states. Paediatr Perinat Epidemiol 1993;7:395-403. 10. Werler MM, Bosco JL, Shapira SK, et al. Maternal vasoactive exposures, amniotic bands, and terminal transverse limb defects. Birth Defects Res A Clin Mol Teratol 2009;85:52-57. 11. Kohn G. The amniotic band syndrome: a possible complication of amniocentesis. Prenat Diagn 1987;7:303-305. 12. Siemers F, Wünsch L, Namdar T, et al. Complete circumferential congenital constriction of the trunk - operation procedures and re- sults. Ger Med Sci 2011;9:Doc17.