Ultrasound Interactive Case Study: Uterine Synechia or Amniotic Band?

Case presentation by: Ozren Mamula M.D. - January, 1998
Email: Ozren.Mamula@public.srce.hr

Case Description:
Pts 20 y/old, PO G2 - previous pregnancy in 1996 was, because of Blighted ovum diagnosed in 9 weeks of gestation, terminated (D,C&E).

This is her second pregnancy. At the beginning of this pregnancy she was admitted to the hospital because of bleeding. On serial TVS scans we were able to follow up vanishing twin phenomenon form 8 to 10 weeks of gestation. Second gestational sac was empty (no signs of embryo or yolk sac). After 10 weeks of gestation, bleeding stopped and she was discharged feeling well. Currently 18 week post LMP, without symptoms, came on routine control. US scan showed normal fetal anatomy, normal posterior/fundal placenta and normal volume of amniotic fluid. In lower uterine segment I saw a single, band-like projection of fibrous tissue structure, going through the amnion. I could see slow movements of the band provoked by fetal movements (arm, head), but no signs of communication or interferens with fetal body. I was unable to visualize any blood flow trough the structure. The only blood flow I could visualize with color doppler was close to the posterior uterine wall and that was a vein. On the images that I've sent, you can see sgital and transversal scan with band-like structure I've described together with color doppler image of the same structure.