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PM 258/04;S0417556. Dr R Shatwan UCHGalway. Clinical. 34 yo female, Para 0, O Pos. Asthma Stillbirth @ 24/40 Macerated male, 450g. Congenital absence (L) lower arm and hand. Placenta. Placenta. Pancreas. Summary. Immature Placenta Multiple Recent Placental Infarcts
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PM 258/04;S0417556 Dr R Shatwan UCHGalway
Clinical • 34 yo female, Para 0, O Pos. • Asthma • Stillbirth @ 24/40 • Macerated male, 450g. • Congenital absence (L) lower arm and hand
Summary Immature Placenta • Multiple Recent Placental Infarcts • Amniotic Band Syndrome • Macerated Male • 24/40 Gestation • Left Forearm Deformity • Acute IUD • Pancreatic Islet Hyperplasia ( gestational DM?)
Amniotic Band Syndrome • Early Amnion Rupture Spectrum • Not Rare: 1/2000 Newborns • Sporadic • Trauma • Negligible Recurrence Risk
Anencephaly Facial Distortion/Proboscis Usual Facial Clefting Eye Defects, Encephalocoele, Meningocoele Placenta Attached to Head and/or Abdomen No Limb Defects 3 Weeks
Usual Cleft Lip Choanal Atresia Limb Reduction/ Polydactyly/ Syndactyly Abdominal Wall Defects Thoracic Wall Defects Scoliosis 5 Weeks
Cleft Palate ( Robin ) Ear Deformation Craniostenosis, plus Short Umbilical Cord Omphalocoele Amniotic Bands Amputation Hypoplasia Pseudosyndactyly Distal Lymphoedema Foot Deformation Hip Dislocation No Internal Anomalies 7 Weeks Onward
Later • Oligohydramnios Deformation Sequence
Amniotic Band Syndrome and Twins • 18 published reports • 17 cases in MZ twins • 1 case in DZ twins • 13/17: 1 twin affected • 4/17: both • 2/13: 1 affected, + 1 acardius anomaly
Pathogenesis • Exogenous Theory • Endogenous Theory • Vascular Theory