Late-onset spontaneous chorioamniotic membrane separation mimicking amniotic band sequence with rapid progression to preterm premature rupture of membranes
Cem Terece, Tuğban Seçkin Keçecioğlu, Simge Tezel Yozgat, Mehmet KeçecioğluAbstract
Objectives
Spontaneous chorioamniotic membrane separation (CMS) diagnosed in the third trimester is rare, and its short-term clinical course remains poorly characterized. We report a case of late-onset CMS with rapid progression to preterm premature rupture of membranes (PPROM).
Case presentation
A 23-year-old woman with a prior cesarean delivery was referred at 35 weeks for suspected fetal macrosomia. At 36+4 weeks, ultrasonography revealed freely mobile, multilayered membranes adjacent to the fetal extremities and umbilical cord, raising concern for amniotic band sequence. Detailed anatomical assessment and color Doppler evaluation demonstrated intact extremities and preserved distal perfusion, supporting a diagnosis of CMS. The patient was admitted for surveillance, and PPROM occurred within hours of diagnosis. Cesarean delivery resulted in a live male infant weighing 4,170 g (Apgar scores 8/9). Intraoperative findings confirmed near-complete amnion–chorion separation.
Conclusions
Late-onset spontaneous CMS may mimic amniotic band sequence and can progress rapidly to membrane rupture. Careful sonographic differentiation is essential. Given the potential for rapid clinical deterioration, close surveillance may be warranted, particularly in late gestation.