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In the first patient a fetal ultrasound study at 12 weeks post\u2010LMP demonstrated a monochorionic (MC) twin pregnancy with a nonviable co\u2010twin and no evidence of amniotic bands. At birth, there was a left cleft lip and palate, and terminal limb \u201creduction\u201d defects with ring constrictions of the left hand and both feet. In the second patient, a routine fetal ultrasound study at 18 weeks post\u2010LMP identified a subhepatic cyst which subsequently resolved. Fetal ultrasound examination and neonatal computed tomography (CT) scan of the liver were consistent with a hepatic infarct due to emboli from the umbilical vein. At birth, patient 2 had acrosyndactyly of the left hand with ring constrictions of the digits and reduction of the left big toe. There was no evidence of abnormal amnion. Postnatal development has been normal in both cases.<\/jats:p><jats:p>We present ultrasound evidence supporting the hypothesis that vascular disruption from death of a co\u2010twin or from in utero embolic infarcts can cause: (1) terminal limb \u201creduction\u201d defects and possibly cleft lip and palate; and (2) ring constrictions similar to those of \u201camniotic band disruption sequence\u201d in the absence of an abnormal amnion. Serial pregnancy ultrasound studies are recommended for evaluation of the development of fetal structural anomalies following ultrasound evidence of a disruptive event in utero. \u00a9 1992 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajmg.1320440513","type":"journal-article","created":{"date-parts":[[2005,6,11]],"date-time":"2005-06-11T16:29:22Z","timestamp":1118507362000},"page":"598-604","source":"Crossref","is-referenced-by-count":33,"title":["Constriction bands and limb reduction defects in two newborns with fetal ultrasound evidence for vascular disruption"],"prefix":"10.1002","volume":"44","author":[{"given":"Margot I.","family":"Van Allen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Siegel\u2010Bartelt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron M.","family":"Zuker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard M.","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ants","family":"Toi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,6,7]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970100806"},{"key":"e_1_2_1_3_1","first-page":"507","article-title":"Fetus papyraceous","volume":"47","author":"Balfour RP","year":"1976","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_4_1","first-page":"1499","article-title":"Twin placenta in perinatal mortality","volume":"61","author":"Benirschke K","year":"1961","journal-title":"NY State J Med"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198804213181607"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(65)90466-7"},{"key":"e_1_2_1_7_1","first-page":"821","volume":"153","author":"Brown DL","year":"1989","journal-title":"Intrauterine shelves in pregnancy: sonographic observations."},{"key":"e_1_2_1_8_1","first-page":"685","article-title":"Multiple gestation complicated by the death of one fetus","volume":"73","author":"Carlson MJ","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970090110"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.165.2.3310098"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420400407"},{"key":"e_1_2_1_12_1","first-page":"446","article-title":"The effects of vasopressin, adrenalin and noradrenaline on the mouse fetus","volume":"38","author":"Davies K","year":"1970","journal-title":"Br J Pharmacol"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320200414"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91374-4"},{"key":"e_1_2_1_15_1","unstructured":"Gilbert\u2010BarnessE DrutRM DrutR GrangeDK OpitzJM:Developmental abnormalities of the umbilical and abdominal wall. 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