QuestionMy doctor told me that an amniotic band was seen on my 20 week ultrasound. She did not give me much information, just that there is nothing I could have done to prevent it, that it was down low at the site of a scar from a previous cesarean (but not whether or not it was attached to my baby) and that so far it has not affected my baby. I am now 24 weeks and have another ultrasound scheduled for right before my 28-week visit. I have done some research myself but find information on the internet to be somewhat lacking. I have a few questions if you can answer them.
What are the chances that if my baby is unaffected at this point, she will stay unaffected?
Are there any factors that affect severity of possible birth defects (for example, can more severe defects occur if the band forms or attaches earlier in pregnancy rather than later)?
What is the chance that an unattached band will eventually become attached?
Am I considered a high-risk pregnancy? Is it still safe for me to exercise or have intercourse with my husband? Some women in support groups say they're put on bedrest or sent to see a specialist, but my doctor acted like it wasn't that big a deal.
I've noticed that she only kicks on my right side, rarely on my left. Is this a sign that something may be wrong?
Is there any benefit to be gained from requesting another ultrasound sooner?
I know it's a lot of qestions, and thank you for your time.
AnswerDear amniotic,
You might want to talk to your doctor further about whether this is an amniotic sheet or a true amniotic band. Amniotic sheets or folds are common and cause no harm to you or your baby. They are found in about 1/200 pregnancies and are thought to be due to the membranes folding over and attaching to scar tissue in the womb, like after a previous D&C or an infection. Amniotic sheets are seen on an ultrasound as thick walls or pillars within the amniotic fluid. The sheet is separate from the baby and will not affect its growth or development in any way. Rarely it may divide up a large area of the uterus which can limit the baby's movements and potentially cause a breech position or early labor.
True amniotic bands or threads are extremely rare and are can be more serious. In early pregnancy the two layers of membrane (the inner amnion and the outer chorion) are separate and should fuse together by the 16th week of pregnancy. If the amnion tears before it fuses with the chorion it can form strands that wrap around the baby and may cause serious abnormalities by disrupting the blood supply - known as amniotic band syndrome. On an ultrasound, very thin strands can be seen floating in the amniotic fluid and may be attached to parts of the baby. With this condition we will usually see another abnormality on US. Other indicators of a sheet vs. a band would be normal fetal movements and the membranes not being attached to the baby. As the baby grows, the sheet is usually compressed against the wall of your uterus, and will no longer be easily visible on US.
That is the information I have for you regarding the conditions. I hope it helps you and answers some of your questions. I do apologize for the delay, as I am in the middle of a personal family crisis. I would very much encourage you to take a list of any questions/concerns still remaining in your mind with you to your next office visit for clarification. I do wish you well.
Brenda
