Case Report: Successful fetoscopic release of pseudoamniotic bands in twin-to-twin transfusion syndrome and twin reversed arterial perfusion sequence: report of two rare cases and review of the literature - Report - MDSpire
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Case Report: Successful fetoscopic release of pseudoamniotic bands in twin-to-twin transfusion syndrome and twin reversed arterial perfusion sequence: report of two rare cases and review of the literature
Clinical Report: Effective Fetoscopic Intervention for Pseudoamniotic Bands
Background
Pseudoamniotic band syndrome (PABS) is an iatrogenic condition that can arise after invasive fetal procedures, leading to significant complications in twin pregnancies. The management of PABS is particularly challenging due to its potential to cause fetal ischemia and limb amputation.
Data Highlights
Characteristic
Value
PABS occurrence in recipients
78.0% (39/50 cases)
Affected fetal limbs
88.2% (45/51 fetuses)
Antenatal detection rate
20.0% (10/50 cases)
Fetuses developing limb amputation without intervention
9.5% (4/42 fetuses)
Median gestational age at fetoscopic release
23.5 weeks (range, 21–27.4)
Newborns requiring further surgery
37.5% (3/8)
Key Findings
PABS is predominantly observed in recipients of TTTS (78.0% of cases).
Affected fetal limbs are the most common site of constriction (88.2% of fetuses).
Antenatal detection of PABS is low, with only 20.0% detected prenatally.
Without intervention, 9.5% of fetuses may develop limb amputation.
Fetoscopic band release has been performed in 8 cases of PABS after TTTS.
37.5% of newborns required additional plastic surgery post-birth.
Clinical Implications
Clinicians should maintain a high index of suspicion for PABS in twin pregnancies following invasive procedures.
Conclusion
Fetoscopic band release is a reported intervention for PABS in twin pregnancies, although the evidence base remains limited.
