Fetoscopic approach to amniotic band syndrome.

BACKGROUND: Amniotic band syndrome (ABS) is an uncommon complication of pregnancy that can result in fetal demise.

METHODS: We present our experience with fetoscopic amniotic band release.

RESULTS: Five patients underwent fetoscopic amniotic band release for preoperatively diagnosed ABS involving at least one extremity. Four of five patients were found to have involvement of the umbilical cord at the time of fetoscopy. One of these four did not have the band released and underwent fetal demise at 24 weeks. All four survivors had good functional outcomes of affected limbs. Two patients developed membrane separation and had preterm deliveries at 32 weeks gestation whereas the other two carried to term. No maternal complications were noted.

CONCLUSIONS: Fetoscopic amniotic band release is safe. Umbilical cord involvement is difficult to assess preoperatively, but when it is present should be treated to reduce the risk of fetal demise.