Pathology
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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Amniotic band syndrome
Etiology, pathogenesis

From so far unknown reasons sometimes one membrane of the gestational sac (amnion) ruptures during the early gestation. Because amnion and chorion practically never fuse, the part of the amnion loosely floats in the uterine cavity, so called amniotic bands. The surface uncovered by the amnial epithelium is “sticky” and easily attaches to the surface of the developing embryo or fetus. By following traction, retraction and winding of the bands around the fetus body during its movments a serious malformations, mutilations of the face, head and body and limbs amputations occur.

Does not happen again in the next gravidity.

Macroscopic appearance
  • atypical clefts of the lip, nose or orbita; extrusion of the abdominal and thoracic organs, brain prolapse (exencephalia), acrania (missing neurocranium)
  • entanglement of the moving limbs or fingers of the fetus into the amnial bands lead to their firm strangulation or amputation
  • constrictions of the umbilical cord by amniotic bands leads to intrauterine death of the fetus
  • ultrasound diagnosis is complicated, but the diagnosis is easily established autoptically and by histologic examination of the strangling bands (they histologically correspond to the normal amnium)
Pictures

Amniotic bands syndrome: Amniotic bands, Macro, autopsy (72125) Amniotic bands, Macro, autopsy (72126) Amniotic bands, Macro, autopsy (72127)

Amniotic bands syndrome, another case, 28-week fetus: Amniotic bands, Macro, autopsy (72038) Amniotic bands, Macro, autopsy (72039)