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The amniotic sheet: a truly benign condition?

K B L Tan1, T Y T Tan, J V K Tan

  • 1Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore. ktbl@pacific.net.sg

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|October 29, 2005
PubMed
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Amniotic sheets, remnants within the uterus, are usually benign. However, complete amniotic sheets, unlike incomplete ones, may be linked to a higher risk of stillbirth, particularly due to cord accidents.

Area of Science:

  • Obstetrics and Gynecology
  • Fetal Medicine
  • Reproductive Health

Background:

  • Amniotic sheets, visualized as uterine shelves, arise from uterine synechiae within the chorion and amnion.
  • Previous research suggests amniotic sheets are generally benign.
  • This study aimed to identify characteristics of amniotic sheets that may predict fetal outcomes.

Observation:

  • Amniotic sheets were detected in 0.14% of 30,476 singleton pregnancies.
  • The study analyzed 44 cases, differentiating between complete (no free edge) and incomplete (free edge visible) amniotic sheets.
  • No association was found between the location of the amniotic sheet and fetal outcome.

Findings:

  • A significant association was observed between complete amniotic sheets and intrauterine death (P = 0.002).

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  • Both intrauterine deaths in the study occurred in cases with complete amniotic sheets.
  • Postmortem examinations indicated cord accidents as the cause of death in these cases.

    • Implications:

    • Incomplete amniotic sheets appear to be benign, consistent with prior literature.
    • Complete amniotic sheets may represent a risk factor for adverse fetal outcomes, including stillbirth.
    • Further investigation into the association between complete amniotic sheets and fetal demise is warranted.