Effect of an amniotic sheet on pregnancy outcomes

Our aim was to evaluate whether the presence of an amniotic sheet affects obstetric and neonatal outcomes.

All singleton pregnant women with and without a sonographic diagnosis of an amniotic sheet between the 16th and 24th weeks of pregnancy were retrospectively identified. Two women without an amniotic sheet were randomly selected from the similar stratified periods as a control group for each case. The demographic characteristics and obstetric and perinatal outcomes were compared between the groups. Multivariable logistic regression was also performed for potential confounding factors. In addition, the subsequent pregnancies of 12 women with an amniotic sheet were followed during the antenatal and postnatal periods.

The prevalence of an amniotic sheet was 1.13%. The risk factors for an amniotic sheet were primiparity, previous normal vaginal delivery, previous dilation and curettage, and previous abortions. When the groups were compared in terms of maternal and neonatal outcomes, the rates of a nuchal cord at birth, breech birth, birth weight of less than 2500 g, preterm delivery (<37 weeks), and neonatal intensive care unit admission were higher in the amniotic sheet group than the control group. There were 2 intrauterine deaths in the amniotic sheet group. In addition, an amniotic sheet was not observed again in any of the subsequent pregnancies of the 12 cases from the amniotic sheet group, and these pregnancies eventuated uneventfully.

An amniotic sheet is associated with an increase in poor obstetric outcomes. Therefore, close monitoring of pregnancies after diagnosis is required.