Case Reports in Medicine 3
determines clinical manifestations through entanglement
by amniotic band, interference with normal development,
and disruption secondary to cleavage of structure already
developed normally [6]. However, these mechanisms are not
able to explain all types of malformations.
Also, the type of deformities depends on time of amniotic
rupture. It is assumed that the minor defect of extremities
occur in late period, while an early amniotic rupture leads
to the most severe visceral disruption, determining the
different prognosis.
The prenatal diagnosis by ultrasound of the amniotic
band is often difficult, and frequently the simultaneous
presence of different congenital deformities suggests the
presence of an amniotic band syndrome.
Unfortunately, in our case, the diagnosis of amniotic
band was not determined during pregnancy. Only rare
cases of strangulation of umbilical cord by amniotic band
have been described in the literature, most of whom were
stillborn [4, 7]. The cause of fetal death during labor is
that the contraction intense enough to stop the blood flow
through the umbilical cord constriction by amniotic band,
determining severe fetal hypoxia [8].
Instead, we report a case of constricted umbilical cord by
amniotic band, but fortunately, in this case, we intervened in
time and despite the severe distress, the fetus was alive and
actually is in good health.
Despite the fact that during labor the different unexpectedumbilicalcordlesionscanoccur,aswehavealready
described in other reports [9, 10], this case suggests that the
ultrasound diagnosis of amniotic band allows an attempted
delivery and can explain signs of severe fetal distress at an
early stage, leading the obstetricians to carefully evaluate the
best route for a safe delivery.