What is Amniotic Band Syndrome & How is it Treated?|Causes, Symptoms of Amniotic Band Syndrome

What is Amniotic Band Syndrome?

Amniotic Band syndrome is a medical condition which comes under the varied conditions that takes place in the child during its birth. The deformity of the parts of the body doesn’t take place at an early stage but after the proper formation. The intensity of the condition can vary from the isolation of a single part to more than one deformed complication. Generally, it’s the legs and arms that are usually affected but it may also affect the head and face and certain other internal organs in certain patients. The actual reason that causes the Amniotic Band syndrome is not so clear and is pretty disputable. One of the theories asserts that the cause for Amniotic Band syndrome takes place within the fetus itself whereas another theory asserts that Amniotic Band syndrome takes place due to some external cause acting on the fetus. It can either be an internal or external factor that can cause the Amniotic Band syndrome as it differs from child to child and the cause for such a disorder would also differ.

Signs and Symptoms of Amniotic Band Syndrome

The symptoms of the Amniotic Band syndrome varies in children, some of the infants may seem to have only a gentle malformation while others may face severe conditions of malformation which can even turn out to be life-threatening. It has been seen that the amniotic band syndrome characteristically starts taking place in the first trimester of pregnancy itself that is within the first 12 weeks.

There has been evidence of various distinctive patterns related to the Amniotic Band syndrome. The three different patterns that come under its category include the condition when one or more than one limb is affected, the next being the severe condition when more than one inborn abnormalities are being seen in the fetus and the last one being the condition the amniotic band syndrome affects the head and face of the infants causing major deformity of the limbs.

Mostly the infants affected by Amniotic Band syndrome seem to have a certain level of deformity of the limbs along with fingers and toes and it is the upper limb of an infant that mostly gets affected rather than the lower limbs. Certain infants may develop only a single arm or leg or feet whereas certain other kinds of deformity seen includes short fingers and toes with the missing of the top portion, binding of the fingers or toes, narrow rings and additional form of tissue being attached to the fingers. The narrow rings that circles around a limb can change the flow of blood in the blood vessels.

One more pattern related to the particular condition of Amniotic Band syndrome is known as the limb-body wall complex which is a fatal condition for an infant. The affected child has prominence of a part of the brain and its encircled membranes through the defect in the skull, facial clefts, and prominence of the viscera through an opening in the wall of the abdomen or chest and also a number of deformities that affects the limbs of the infant.

The third and the last pattern incorporates the craniofacial anomalies which include incomplete closure of the mouth roof, small and underdeveloped eyes, facial clefts, deformity causing to alter the shape and size of the skull and also narrowing of the passageway of the nose. The heads of the infants affected by the amniotic band syndrome are adhesive to the placenta.

Causes of the Amniotic Band Syndrome

The underlying causes and mechanisms that are the reason for the amniotic band syndrome in infants are quite compound and debatable[1]. There are different kinds of theories that have been researched and proposed by the researchers and which have come to be known as extrinsic thesis and intrinsic thesis. The two approaches provide two completely different theories in which the extrinsic theory expresses that the Amniotic Band syndrome takes place due to certain underlying factors working within the fetus. Whereas the other approach – the intrinsic theory- expresses that the factors take place within the internal area of the fetus.

Mechanisms of Amniotic Band Syndrome

Extrinsic Theory: It suggests that the development of the Amniotic Band syndrome shows that the particles of the tissue get separated from the internal layer of the amniotic sac. The amniotic sac is referred to as the narrow membrane that totally surrounds the developing embryo or growing fetus. The sac carries a fluid that reinforces cushions and safeguards the growing fetus. The amniotic sac comprises of two layers – the exterior layer is called the chorion and the internal layer is called the amnion.

Intrinsic Theory: There were certain researchers who found out that explanation of all cases under the Amniotic Band syndrome through the extrinsic theory was not possible; hence intrinsic theory was evaluated[2]. The external theory is unsuccessful to define the reason for an intact amniotic sac in certain infants suffering from amniotic band syndrome, the exact reason for the lofty number of deformities that affects the internal organs in certain patients and also the reasons for the deformity of the limbs of certain infants who are not affected by the amniotic band syndrome.

Diagnosis of the Amniotic Band Syndrome

The condition of Amniotic Band syndrome is generally diagnosed in the infants during the time of birth or soon after that, depending on the typical findings through the examination of the body. The minimum level of diagnostic criteria includes the findings of the deformities of the limbs, fingers or toes of the infant that may include severe abnormalities, binding between the digits or parts of tissue connected to the end portion of the fingers.

With the change of time, the technology and medical science is advancing at a great speed. Hence nowadays there are also techniques through which it can be found out whether an infant is affected by Amniotic Band syndrome even before birth with the help of some professional visual representation technique that includes fetal ultrasonography that may show the defective features.

Treatment of the Amniotic Band Syndrome

The medical treatments provided for infants or children affected by the amniotic band syndrome are both indicative and sensitive. For example in case of infants who have incomplete growth of lungs in them and are suffering from the underdeveloped respiratory system leading to problems in respiration, therapies in such patients that measures and support oxygen and associated medical help are needed. Under certain circumstances where the infants suffer due to the ring like stenosis, entangled toes and fingers or split lip, clubbing of the foot, several surgical procedures may be used for the reconstruction or repair of the malformed parts of the infant.

Substantial and professional treatment is also necessary along with the surgical treatment so that the children may learn to make complete use of their arms, fingers, legs, and toes. In some cases, surgeries do take place even before the birth of the child so that the doctors could get the infant rid of it that may lead to the mutation of the limbs of the baby. Research are being conducted so as to find out whether genes have a role to play in the occurrence of the amniotic band syndrome as it could help in due course of time to explain the underlying reasons for the causes and progression of the disorder.

Conclusion

Amniotic band syndrome is a rare kind of inborn disorder or condition that may take place in the infant even without genetic interference or hereditary temperament. It involves the entangling of the fetus in parts of amniotic tissue and causes a range of malformation and genetic mutation. The very basis of treatment for the amniotic band syndrome is the medical surgery that leads to the reconstruction and repair of the deformed limbs and utero fetal surgery is also an upcoming procedure for the treatment of the amniotic band syndrome.

References:  

  1. Rezai, S., Faye, J., Chadee, A., Gottimukkala, S., Upadhyay, R., & Lara, C. et al. Amniotic Band Syndrome, Perinatal Hospice, and Palliative Care versus Active Management. Case Reports In Obstetrics And Gynecology, (2016). 1-4. doi: 10.1155/2016/9756987
  2. Seeds, J., Cefalo, R., & Herbert, W. Amniotic band syndrome. American Journal Of Obstetrics And Gynecology, (1982). 243-248. doi: 10.1016/0002-9378(82)90574-9

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