Fetal

A woman in her early 30s, gravida 2, para 1, was referred at 13 weeks ’ gestation for a first-trimester nuchal translucency screening examina-tion. The patient had a history of light bleeding earlier in the pregnancy, which had resolved. An obstetrical sonogram was performed both transabdominally and transvaginally, which sho-wed an active fetus with a normal heart rate of 156 beats per minute. However, the fetal head was located low in the uterus, completely deta-ched from the fetal body (Figures 1 and 2). The abdominal circumference and femur length were consistent with 13 weeks ’ gestation, whereas measurements of the biparietal diameter and head circumference measured 12 weeks ’ gestation. The anatomy of the trunk and limbs appeared normal. Transvaginally, amniotic bands were seen encom-passing the detached head (Figure 3). Overlapping of the fetal cranial bones (Spaulding’s sign) was also appreciated. Normal movements of the fetal trunk and lower extremities were observed. The upper extremities, however, remained adducted Amniotic band syndrome (ABS) occurs second-ary to rupture of the amnion in early pregnancy. This may result in entrapment of fetal structures, which in turn can cause a wide range of con-genital malformations, including constriction or amputation. Presented here is a case involving a live fetus at 13 weeks ’ gestation with the rare finding of fetal decapitation caused by amniotic band syndrome. Key words: decapitation, fetal malformations, amniotic band syndrom