General Discussion
Amniotic bands is an abnormal condition of fetal development in which fibrous
bands of tissue that originate from the amniotic sac encircle and constrict
certain fetal areas, disrupting fetal growth. The amniotic sac is the thin,
membranous sac that contains amniotic fluid and the developing fetus during
pregnancy. Amniotic band formation may be associated with early rupture of the
amniotic membrane, chronic leakage and abnormally decreased levels of the fluid
surrounding the developing fetus (oligohydramnios), and abnormally decreased
fetal movements. Associated structural malformations are extremely variable and
may depend upon the time of amniotic band formation during fetal development.
Such deformities may include abnormalities of the arms and legs (limbs), fingers
and toes (digits), spine, lungs, facial area, skull, and/or abdominal and chest
region.
[*] [P] Congenital
Constricting Bands
from OMIM
A considerable body of observations indicated that rupture of the amnion and
constriction of members which are displaced through holes in the amnion are
involved. Amputated parts have been recovered in some instances ...
Congenital
Constriction Band Syndrome
Southern Orthopaedic Association.
"... Congenital annular constricting bands ( CACBs ) ... incidence
estimated to be between one in 5,000 to 10,000 live births ... presents itself
with constriction bands, auto amputations, syndactyly, acrosyndactyly, and
visceral anomalies ..." [P] Gastroschisis
in association with a limb - body - wall ( LBW ) complex
[P] Presumptive limb
body wall complex detected by Ultrasound - ( limb body wall )
" ... Limb body wall complex refers to combination of disruptive and lethal
abnormalities which start early in the gestational process ... include cranio-facial
abnormalities, scoliosis, ventral body wall defect ( thoraco - abdominoschisis
), limb deformations, short umbilical cord, and others ... include short
umbilical cord syndrome, body-stalk anomaly and amniotic band syndrome ..."
Amniotic
Band Syndrome: a population-based study in two Australian states.
by C. Bower, King Edward Memorial Hospital, Western Australia.
"A search for cases of amniotic band syndrome was made in two
population-based Australian birth defects registries ... 2.03 per10,000 births
... more common in mothers younger than 25 years of age, and in first birth
..."
Intra-amniotic Band-like
Structures
Martin Necas, RDMS, RVT
"... Band-like structures within the gestational sac are frequently noted
on obstetric sonograms during the first and second trimester of pregnancy ...
confusion still exists in the medical community about the precise diagnosis in
these cases ... raises undue concern about the proper development ..."
An
example of Amniotic Constriction Band Syndrome
An article by Damian McCormack.
Annular constriction bands can involve anypart of the body and vary from minor
digital deformities to reports of nerve palsies and pseudoartroses of long bones
to congenital amputations, including acase report of a congenital decapitation!
Illustration
Limb Body Wall ( LBW ) complex with constricting amniotic bands
Significance
of fetography in prenatal diagnosis of limb body wall complex ( LBWC )
by H. Fukumasu, Department of Obstetrics and Gynecology, Osaka City University
Medical School, Japan.
"... The major difficulty we found was severe oligohydramnios or a very
complex relationship between the herniated viscera and the deformities."
[Spanish] Caudal
appendix in sequential defects of amniotic rupture
Pathology Unit of the Acapulco General Hospital.
" ... amniotic adhesion, limb body wall complex, and the presence of a
pseudotail ... "
Illustration- Abdominal Wall
Defect, Stomach
Body-Stalk Anomaly.
Illustration
- Lateral Abdominal Wall Complex, ( LBWC )
Illustration
- Disrupted lower extremities and left hand ( LBWC )
Amniotic Bands and
Sheets
" ... Abnormalities of the membrane include amniotic sheets and amniotic
bands ... overall they affect around 0.8% of pregnancies ...amniotic sheets are
the most common ..."
Adam
Complex ( amniotic deformity, adhesion, mutilation )
"... Eight patients with the craniofacial defects and limb anomalies ofthe
ADAM complex ... facial abnormalities comprise clefts and distortion and
dislocation of craniofacial structures ... ADAM complex varies
enormously..."
Limb
deformations in oligohydramnios sequence: effects of gestational age and
duration of oligohydramnios
An article by C. Christianson, D. Huff and E.McPherson. "... The causes of
oligohydramnios included premature rupture ofmembranes ( 44 cases ), fetal renal
insufficiency ( 25 cases ), idiopathic ( 15cases ), and twin-twin transfusion (
6 cases ) ..."
Lower-Limb Pediatric
Prosthetics: General Considerations and Philosophy
Preventing Deformities
"... Amniotic band syndrome is a rare condition ... field of operative
fetoscopy, or operations on the baby while it is still in the womb... they found
that if the constriction was released, the limb could be rescued... in January
1997, Dr. Quintero and his colleagues tried the same concept on a21-week old
human fetus ... the procedure was performed through an endoscope, afiber optic
camera inserted into the uterus ..."
In
utero Lysis of Amniotic Bands
Quintero RA; et al ... Ultrasound Obstet Gynecol 1997 Nov;10(5):316-20 ...
Fetuses with amniotic band syndrome with associated limb constriction in which
the amniotic band was surgically interrupted to avoid spontaneous amputation of
the extremity ...
Amniotic
Band Syndrome in Fetal Lambs. I: Fetoscopic Release & Morphometric Outcome
Cromblehome TM; J Pediatr Surg 1995 Jul;30(7):974-8.
Eight fetal lambs underwent banding of their extremities with umbilical tape at
100 days' gestation ... There were no differences between fetoscopically
released limbs and control limbs ...
Limb
Amputation in Amniotic Band Syndrome: Serial Ultrasonographic and Doppler
Observations
Ultrasound Obstet Gynecol 1997 Nov;10(5):312-5 ...
Bilateral fetal lower limb edema diagnosed previously. Ultrasonography showed a
constriction ring around both legs, and ... This was followed by the gradual
bending, breaking and resorption of the tibia and fibula of the right leg.
Between weeks 30 and 34, gradual shrinkage of the remains of the right leg
beneath the knee was recorded by serial ultrasonic observations. At the 38th
week of gestation, a male infant was born by normal vaginal delivery.
Examination at birth revealed amputation of the right leg below the knee, with a
denuded end of the stump ... This case afforded us the opportunity of inutero
following of natural limb amputation in the amniotic band syndrome ...
International Child Amputee
Network
Amniotic
Bands
Disease Information by National Organization for Rare Disorders
Amniotic Band
Sequence ( ABS )
Malcolm Cheng, MD, FAAP, FRCPC ...
B. Historical Perspective ... Hippocrates: First suggested amniotic bands as a
cause of limb deformities or amputations. 1812: Chaussier described 3 cases of
upper limb separation at birth ... 1975: Kino, et. al. showed haemorrhagic
disruption of tissue in rats preceded limb deformation ...
Congenital Deformities
Teaching Files: The
Placenta
A partial list of fetal and neonatal conditions which should lead to placental
examination include congenital malformation, stillbirth, neonatal death, fetal
growth retardation of any type, hydrops, meconium in amniotic fluid ...
Amniotic Band Syndrome
Luís Flávio Gonçalves, MD, Philippe Jeanty, MD, PhD ... Vanderbilt University
...
Synonyms: ADAM complex ( amniotic deformities, adhesion, mutilation ), amniotic
band sequence, amniotic disruption complex, annular grooves, congenital
amputation, congenital Constricting bands, streeter bands, transverse terminal
...
Definition: Amniotic band syndrome is a set of congenital malformations ranging
from minor constriction rings and lymph-edema of the digits to complex, bizzarre
multiple congenital anomalies that are attributed to amniotic bands that stick,
entangle and disrupt fetal parts ...
Prevalence: The prevalence for live births is 7.7 :10,000; for spontaneous
abortions it can be as high as 178:10.000 ...
[Ukrainian] Amniotic
Constricting Band Syndrome Fact Sheet for Specialists
Pathogenesis ... Clinical picture ... Associated anomalies ... Prenatal
diagnosis ... Prognosis ... Delivery management ... OMIM number
BRTS
