Lethal malformation characterized by attachment of viscera to placenta with short or absent umbilical cord

Gross distortion with complete loss of anatomic landmarks

Abnormal fetus inseparable from placenta

Large thoracoabdominal wall defect without covering membrane; often complete evisceration

Absent/very short umbilical cord

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  Vessels seen running from placental surface to fetal torso

Scoliosis, often severe

Limb defects may be present but not major feature as is often seen with amniotic bands

Head usually unaffected

Body stalk anomaly is most likely diagnosis with severe abdominal wall defect (AWD), scoliosis, and “stuck” fetus

In other severe defects, AWD fetus will not be attached to placenta (amniotic bands, pentalogy of Cantrell)

Be vigilant at time of nuchal translucency screening

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  Early diagnosis allows earlier/safer termination of pregnancy

Use 3D US to help define anatomic relationships

Color Doppler often useful to clarify confusing anatomy and look for umbilical cord

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  Identify fetal vascular landmarks (e.g., iliac bifurcation, renal arteries)

In fetus with large AWD, look for free-floating loops of cord

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  Absent or short cord = body stalk anomaly

  
  
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  Normal cord makes amniotic bands more likely

  
  
  
  
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    Roll patient, look for delicate bands as fetus “floats” away from placenta