Intrauterine synechiae-Amniotic sheets visualized in the uterus

The differential diagnosis of reflective intrauterine membranes during pregnancy includes amniotic bands of fetal origin or membranes of combined maternal-fetal origin. While the former have been associated with fetal transverse reduction defects or the lethal amniotic band syndrome, the latter are usually benign and consist of a preexisting uterine septation or synechia around which the fetal membranes fold or become enveloped.

Intra Uterine Synechiae:
(also known as "amniotic sheets" or "amniotic folds")

A synechia is a term meaning an "adhesion", or a fibrous scar. Uterine synechiae have also been referred to as "amniotic sheets" or "amniotic folds". 

Many patients with sonographically demonstrable uterine synechia have clinical history 

of uterine instrumentation or uterine infections to explain scar formation. Most commonly, uterine synechiae are noted as an incidental finding on obstetric sonograms.

 In general, synechiae do not interfere with the development and growth of pregnancy, 

and are rarely associated with any complications.  There is some evidence to suggest that large synechiae may be the cause of malpresentation due to partial compartmentalization of the uterine cavity, and may also be associated with lower birth weight.

Visualization of a band-like structure should not be confused with amniotic band syndrome especially when thorough fetal anatomy survey reveals no structural 

anomalies.

fetal face .nose and lip seen.

normal fetal hand and wrist seen.

coronal view of fetal face with upper limb

Here We present an unusual case in which a patient was noted at 30 weeks' gestation to have an 

intrauterine membrane of undetermined origin, appearing to contain a pulsating vessel

Color Doppler imaging and Doppler flow velocimetry clearly depicted a pulse synchronous with the

maternal heart rate, defining the membrane as amniotic membranes surrounding a preexisting

uterine synechia and not a true amniotic band. 

There is some evidence to suggest that large synechiae may be the cause of 

malpresentation due to partial compartmentalization of the uterine cavity.

There were no obvious structural anomalies seen.

Visualization of a band-like structure should

 not be confused with amniotic band syndrome especially when thorough fetal anatomy

 survey reveals no structural anomalies.

There is some evidence to suggest that large synechiae may be the cause of 

malpresentation due to partial compartmentalization of the uterine cavity 

^{Here the fetus is of 30 weeks gestation  in transeverse lie}

Visualization of a band-like structure should not be confused with amniotic band 

syndrome especially when thorough fetal anatomy survey reveals no structural 

anomalies.