Discussion:
Amniotic band sequence is a variable spectrum of congenital anomalies
that result from in utero entrapment of fetal parts by amniotic bands.
The incidence of amniotic band sequence is estimated to be between
1/1,200 to 1/15,000 live births and 1/70 stillbirths1.
The exact etiology of amniotic band sequence is unknown, however it is
believed to be related to intrinsic and extrinsic factors. Intrinsic
factors involve the disruption of the developing embryonic disk.
Extrinsic factors involve the disruption of the amnion that causes
entrapment of fetal part by mesodermal bands2.
The diagnosis of amniotic band sequence can be made prenatally or
postnatally. Prenatal diagnosis is made via fetal ultrasound that
detects constriction rings, limb amputation, craniofacial or body wall
defects. Postnatal diagnosis of amniotic band sequence should be
suspected in newborns with amniotic bands associated with limb
constriction or amputation, body wall defects, and craniofacial
abnormalities. Other abnormalities that have also been reported are a
short umbilical cord and talipes equinovarus. Examination of fetal side
of the placenta will often reveal amniotic strands2.
Differential diagnosis of ABS includes genetic syndromes (such as
Adams-Oliver syndrome), teratogens (such as poor glycemic control early
in pregnancy and thalidomide exposure), and synechiae and
septa1.
Prenatal management of ABS include fetoscopic in utero lysis of bands.
After birth, a detailed physical exam along with imaging studies to
determine the extent of ABS should be performed. Primary treatment for
newborns is plastic and reconstructive surgery. The prognosis of ABS
depends on the extent of the defects3.
AUTHOR CONTRIBUTIONS: Jesus Ruiz: Conceptualization; visualization;
writing – original draft.
ACKNOWLEDGEMENT: None.
FUNDING INFORMATION: None.
CONFLICT OF INTEREST STATEMENT: The author declares no conflict of
interest.
DATA AVAILABILITY STATEMENT: Data sharing not applicable to this article
as no datasets were generated or analyzed during the current study.
PATIENT CONSENT STATEMENT: Written informed consent was obtained from
the patient to publish this report.