摘要目的:探讨羊膜带综合征（amniotic band syndrome，ABS）宫内治疗的临床意义。方法:回顾性分析2020年8月至2024年8月重庆医科大学附属妇女儿童医院产科收治的10例ABS孕妇的临床资料，其中胎儿宫内手术5例，干预的指征为缩窄环形成伴有远端肢体水肿或血流异常，对应Hüsler标准的2~3期。分析孕妇的一般情况、诊断孕周、手术方式、宫内治疗时间、围产结局等。通过电话、微信或门诊随访其预后。结果:10例ABS孕妇年龄为（32.0±4.0）岁，妊娠次数为（2.7±1.3）次，诊断孕周为（20.1±3.6）周，产前诊断8例。2例继发于胎儿宫内治疗后，其余8例为自发性ABS。7例存在早孕期阴道流血和保胎病史；羊膜带累及四肢9例；胎死宫内1例，减胎1例，流产1例，引产1例，活产分娩6例。胎儿镜手术6例，5例行羊膜带松解术，其中3例双通道剪刀切断，2例单通道激光切断。宫内治疗孕周为（20.2±2.8）周，手术时长为（70.6±31.0）min。活产的新生儿中均未发生截肢情况，部分新生儿需手术矫正，均预后良好。结论:产前胎儿宫内干预可改善分期2~3期ABS新生儿的结局。

abstractsObjective:To explore the clinical significance of intrauterine interventions for amniotic band syndrome (ABS).Methods:A retrospective study was conducted to analyze the clinical data of 10 pregnant women with ABS admitted to the Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University from August 2020 to August 2024. Five cases underwent fetal intrauterine surgery. Indications for intrauterine surgery of ABS included constriction with distal limb edema or vascular abnormalities, corresponding to stages 2-3 of the Hüsler classification. General data of pregnant women, gestational age at diagnosis, surgical approaches, operation duration, and perinatal outcomes were retrospectively analyzed. Postnatal follow-up was performed via telephone, WeChat, or outpatient visits.Results:Among the ten cases of ABS, the average maternal age, gravidity, and the average gestational age at diagnosis were 32.0±4.0 years, 2.7±1.3, and 20.1±3.6 weeks, respectively. Eight cases were diagnosed before delivery. Two ABS cases were found after fetal intrauterine therapy, while the other eight cases were spontaneous ABS. Seven cases had a history of vaginal bleeding and pregnancy maintenance during the first trimester, and nine had the band involvement of limbs. There were one case of fetal death, one case of selective reduction, one case of miscarriage, one case of induced abortion, and six cases of live births. Fetoscopic surgery was performed in six cases. Amniotic band lysis surgery was performed in five cases, involving three treated with dual-port scissors division and two treated via single-port laser division. The average gestational age at intrauterine treatment was 20.2±2.8 weeks, with a mean operative duration of 70.6±31.0 minutes. None of the live-born neonates required limb amputation. However, some neonates underwent postnatal surgical interventions, and all of them had a good prognosis.Conclusions:Prenatal intrauterine intervention may improve neonatal outcomes of ABS at stage 2-3.