Skin dimpling as a delayed manifestation of traumatic amniocentesis

A 2-month-old infant girl was seen for marks on her abdomen. Born after a 39-week, 2-day normal twin gestation to a 37-year-old healthy multiparous mother, the prepartum history for "Baby B" was significant only for amniocentesis at 17 weeks' gestation, where three needle insertions were required for obtaining amniotic fluid from "Baby B." During amniocentesis, performed under ultrasound guidance by an experienced obstetrician, the amniocentesis needle was misplaced in the fetal abdomen in one of the failed attempts. No evident adverse sequelae were noted and the pregnancy proceeded without complication. As the baby gained weight, by 6 weeks of life two indentations appeared on the skin, becoming more pronounced as the baby became chubbier. Aside from this finding, the baby was otherwise healthy. Close examination revealed nontender skin-colored focal puckering on the right anterior lower abdomen and the right flank. No induration, fluid exudation, or fistulous opening was evident. At 13 months of age, the lesions remained stable and asymptomatic.