AMNIOTIC BAND CONSTRICTION

  • A congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero.
  • Other names: “amniotic band syndrome”, “ADAM complex”, “Amniotic band sequence”, “Congenital constriction bands”, “Pseudoainhum”
  • Constriction of limbs by amniotic bands may result in:
    • Constriction rings around the digits, arms and legs
    • Congenital lymphedema: swelling of limbs further from the point of constriction
    • Congenital amputation: Cutting off of digits, arms and legs
  • Associated deformities:
    • Clubfoot (31.5%); 20% occurring on both feet
    • Clubhands
    • Cleft lip
    • Cleft palate
    • Hemangioma
  • Decreased movement of the fetus: sign of serious problem which may include ABS.
    • Rare occurence: membrane wraps around the placenta or the neck of the baby in the womb causing strangulation and death.

DIAGNOSIS

  • Physician may do/request:
    • History & Physical Exam
    • Difficult to detect
      • Individual strands are small and hard to see on ultrasound
    • Often the bands are detected indirectly because of the constrictions and swelling of limbs, digits, etc.
  • Misdiagnosis is also common, so if there are any signs of amniotic bands, further detailed ultrasound tests should be done to assess the severity
  • Aside from ultrasound, physician may do/request:
    • 3D ultrasound and MRI
      • For more detailed and accurate diagnosis of bands and damage/danger to the fetus

 

RECOMMENDED MEDICATIONS

  • Fetal surgery
    • In rare cases, if diagnosed in utero
    • To save a limb in danger of amputation or deformity
    • Would not be attempted if neither vital organs nor the umbilical cord were affected.
    • Has been successfully performed on fetuses as young as 22 weeks
  • Plastic and reconstructive surgery
    • Done after birth to treat the resulting deformity.
  • Physical and occupational therapy
  • Prosthetics

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