Alternative names for Amniotic Band Syndrome:

ADAM Complex (Amniotic Deformity, Adhesions and Mutilations). Amniotic band disruption complex or sequence. Amniotic bands and sheets. Annular constriction bands. Congenital ring constriction. Congenital transverse defects. Constriction band syndrome. Intrauterine amputation. Limb-body Wall Complex Streeter’s dysplasia. TEARS (The Early Amnion Rupture Spectrum).

INCIDENCE:

Amniotic Band Syndrome (ABS) affects approximately 1:1200 to 1:15000 live births. It is also believed to be the cause of 178 in 10,000 miscarriages.In 50% of the ABS cases the baby does not survive. It was once thought to be a rare anomaly but recent literature supports that the incidence occurs more often than once thought. Amniotic Band Syndrome is NOT GENETIC, which means it is not inherited,it can't be passed on. It's a random occurrence that can happen to anyone. Up to 50% of cases have other congenital anomalies including cleft lip and palate and clubfoot deformity. Hand and finger anomalies occur in up to 80%.

CAUSES:

Amniotic Band Syndrome is not genetic (i.e. not inherited). It is extremely unlikely that ABS will affect a future pregnancy. To date, no prenatal factors have been associated with ABS. The commonly accepted view is that ABS occurs when the inner membrane (amnion) ruptures without injury to the outer membrane (chorion), this exposes the baby to fibrous sticky tissue (bands) of the placenta which can float in the waters of the uterus, these fibrous tissues can entangle the baby reducing blood supply and causing congenital abnormalities. It is believed to happen within the first 12 weeks of pregnancy.If the rupture occurs after the first 45 days then usually only the limbs are affected.If the rupture occurs within the first 45 days than,the chance of more serious abnormalities can occur.In some cases a complete "natural" amputation of a digit(s) or limb may occur before birth or the digit(s) or limbs may be necrotic (dead) and require surgical amputation following birth.

TREATMENT:

Although at the time of diagnosis some cases of ABS show congenital deformities beyond surgical repair (e.g., amputations, eccentric encephaloceles), some babies may show an isolated constriction of an extremity without amputation. In these cases, it has been speculated that the limb constriction can lead to subsequent amputation or significant functional impairment of the extremity. With Amniotic Banding no two cases are exactly alike so treatment depends on which body part the band was wrapped around and the severity of the abnormality it caused.

There are several abnormalities that are relatively consistent: syndactyly (webbed digits), distal ring constrictions, deformity of the nails, congenital band indentations,clubhands and feet( a strong relationship between ABS and clubfoot exists, a 31.5% of associated clubfoot deformity and ABS can be correlated with 20% occurring bilaterally),cleft lip, and/or cleft palate, hemangioma, progressive lemphedema ( swelling ), stunted growth of fingers and toes and limb length discrepancy. Less common are pseudarthrosis, metatarsus adductus, peripheral nerve palsy, dystrophic nails, postnatal gangrene, dislocated hip, visceral body wall malformations, eccentric craniofacial synostosis defects and skin-tubed pedicles, fetal death associated with amniotic band strangulation of the umbilical cord has also been reported.

Seeing that no two cases are exactly alike, only some of the above are present in each individual case. When asymmetric fetal anomalies are observed ultrasonographically or after a child is born, regardless of the presense of or absense of fibrous membranes, ABS should be considered.