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Fetal Diagnosis and Therapy 2015Amniotic band syndrome (ABS) is uncommon. We review our single-institutional experience to define its natural history and outcomes.
INTRODUCTION
Amniotic band syndrome (ABS) is uncommon. We review our single-institutional experience to define its natural history and outcomes.
MATERIALS AND METHODS
We conducted a retrospective analysis from a single, tertiary referral center of patients evaluated for and confirmed to have ABS from 1997 to 2012.
RESULTS
Twenty-eight patients had confirmed ABS. The mean ± SD maternal age was 27.9 ± 5.9 years, and the mean gestational age at diagnosis was 20.7 ± 3.8 months. Oligohydramnios was reported in 4 patients. Eleven patients had membrane disruption, of whom 4 had undergone a prior percutaneous intervention. Extremities were the most common site affected (n = 20), followed by the umbilical cord (n = 7), abdomen (n = 5), limb-body wall complex (n = 5), head (n = 1), and chest (n = 1). Nine patients were felt to be candidates for fetal intervention; 5 underwent fetoscopic amniotic band lysis with 4 survivors. Overall survival, excluding 3 terminations, was 74%. There were 5 fetal demises and one neonatal death. Cord involvement was higher in nonsurvivors (67%) compared to survivors (19%, p = 0.05).
DISCUSSION
ABS most commonly involves the extremities. Membrane disruption is not always present. Fetoscopic lysis is appropriate for select patients, and special consideration should be given for cord involvement, which is associated with a worse outcome.
Topics: Abortion, Induced; Adult; Amniotic Band Syndrome; Female; Fetal Death; Fetoscopy; Gestational Age; Humans; Infant, Newborn; Perinatal Death; Pregnancy; Retrospective Studies; Young Adult
PubMed: 25531236
DOI: 10.1159/000358301 -
The Journal of Maternal-fetal &... Nov 2017Congenital upper limb differences are frequently associated with complex syndromes. Ultrasonography is considered as the first-line diagnostic modality, and fetal MRI... (Review)
Review
Congenital upper limb differences are frequently associated with complex syndromes. Ultrasonography is considered as the first-line diagnostic modality, and fetal MRI can be useful to further evaluate ill-defined areas. Genetic and non-invasive prenatal testing help to identify the underlying genetic disorder. The diagnostic assessment is a multidisciplinary task that should involve early prenatal consultations with specialists involved in case management and treatment planning. Obstetricians, geneticists, radiologists, psychologists and dedicated surgeons are needed to provide good parental education, prenatal and postnatal care, and successful outcomes. The purpose of this review is to provide an overview of the clinicopathologic background, current diagnostic and imaging procedures in affected fetuses.
Topics: Algorithms; Amniotic Band Syndrome; Female; Fetal Therapies; Genetic Testing; Humans; Magnetic Resonance Imaging; Pregnancy; Ultrasonography, Prenatal; Upper Extremity Deformities, Congenital
PubMed: 27809626
DOI: 10.1080/14767058.2016.1256989 -
Journal of Orthopaedic Case Reports Dec 2022The term Streeter's syndrome is a term used to describe rare congenital malformations that includes a variety of clinical presentations usually consisting of a...
INTRODUCTION
The term Streeter's syndrome is a term used to describe rare congenital malformations that includes a variety of clinical presentations usually consisting of a constriction band around a part of the body which can be as superficial as involving just the skin which can be only cosmetic and asymptomatic or can be as deep as causing restricted circulation distally which may be in incompatible with life. Such conditions are remarkably rare accounting for an incidence range from 1:1.2 k to 1: 15 k live births and 178:10 k spontaneous abortions [1]. Males and females are uniformly affected. Almost all cases are sporadic; extremely rare evidence of familial transmission. The entity has been described in the literature in 34 different terms, (such as amniotic rupture sequence, ADAM complex, constriction band syndrome, Streeter's dysplasia, etc.) due to its extremely variable clinical features and lack of understanding of the etiology. This results in a lack of understanding and creates unnecessary stress for the surgeon/physician as well as the parents.
CASE REPORT
We discuss case reports of two such cases with their simple nature of treatment with their outcomes.
CONCLUSION
There is a significant deficit in the education of cases with low incidence, such is the case with pediatric patients presenting with amniotic bands, which usually present and are associated with Congenital Talipes Equino Varus deformity. In such cases, improper or incorrect treatment and/or neglect of the constriction may lead to the vascular deficit and eventually auto-amputation of the segment distal to the amniotic band.
PubMed: 37056605
DOI: 10.13107/jocr.2022.v12.i12.3460 -
Plastic and Reconstructive Surgery Apr 2022Many patients with constriction band syndrome will seek treatment to improve limb function and cosmesis. Although several techniques for excision are reported, cosmetic...
BACKGROUND
Many patients with constriction band syndrome will seek treatment to improve limb function and cosmesis. Although several techniques for excision are reported, cosmetic and functional deficits can persist, including hourglass deformity, lymphedema, and inadequate band excision with resultant neurovascular compromise, which may lead to revision surgery, including amputation. The authors present a novel technique that uses multiple continuous opposing Y-to-V-plasties in a single or staged manner to correct extremity constriction bands.
METHODS
Seven patients with 10 involved extremities were included in this retrospective case series. Patient demographics, associated abnormalities, and operative indications were collected from medical records. The primary outcome measures were primary wound healing and release of the constriction band. Secondary outcomes measures were perioperative complications and the need for revision surgery.
RESULTS
All patients achieved primary closure with excellent healing in one or two stages. No infections or scar complications occurred, and no revision surgery of the band was required. One patient had mild indentation of scar tissue after their second stage, which improved with scar massage. One patient who had preoperative sciatic compression neuropathy and an insensate foot secondary to band constriction developed chronic calcaneal osteomyelitis requiring a subsequent Syme amputation. Postoperative lymphedema occurred in two patients, which resolved with the use of compression bandages over several weeks.
CONCLUSION
Use of multiple continuous opposing Y-to-V-plasties is a safe and effective technique for adequate constriction band excision without residual hourglass deformity and good functional outcomes for patients with partial or circumferential constriction bands.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Topics: Amniotic Band Syndrome; Cicatrix; Constriction; Constriction, Pathologic; Humans; Infant, Newborn; Lymphedema; Retrospective Studies
PubMed: 35188902
DOI: 10.1097/PRS.0000000000008954 -
Seminars in Plastic Surgery Aug 2019Scarless healing has long been the holy grail for plastic surgery. While historically fetal surgery has tempted plastic surgeons with the allure of scarless correction... (Review)
Review
Scarless healing has long been the holy grail for plastic surgery. While historically fetal surgery has tempted plastic surgeons with the allure of scarless correction of congenital abnormalities, the risks far outweighed the benefits and these interventions never materialized. Current advances in fetal surgery with minimally invasive fetoscopic surgery have made these early fetal interventions safer, leading to expanding applications. While the plastic surgeon's role is limited as of yet, this article provides a review of the history of fetal surgery and the advances that may become relevant to the future plastic surgeon.
PubMed: 31384237
DOI: 10.1055/s-0039-1693431 -
Spectrochimica Acta. Part A, Molecular... Feb 2023Studies with the use of FTIR and FTR methods to find spectroscopic biomarkers within the 1740 cm band of pathological tissues found that oxidative stress, including... (Review)
Review
Studies with the use of FTIR and FTR methods to find spectroscopic biomarkers within the 1740 cm band of pathological tissues found that oxidative stress, including damage to epidermis and structural changes in pathological amnion and placenta tissue, are associated with the occurrence of products of lipid peroxidation and have impact on fluidity and transport function of membranes. In particular, the findings show that the absence of a marker lipid band of approx. 1743 cm and the occurrence of a minimum of 1764 cm (FTIR) and 1734 cm (FTR) testify to the integrity and absence of damage in the allogeneic dermis, while the presence the 1743 or 1747 cm bands indicates denaturation of the thermally or electrically burned epidermis. The absence of a marker lipid band of approx. 1736-1740 cm for a healthy placental and amniotic tissue and the presence of a band of 1740 cm indicate placental gestosis, while the presence of a band of 1742 cm indicates hypotrophy. The 1738 cm bands indicate amniotic macrosomia. Structural changes caused by tissue modification with antioxidants, which were observed on individual samples: the L-ascorbic acid (presence of a lipid band marker at a frequency of 1755 cm), sodium ascorbate (disappearance of the marker band), orthosilicic acid (disappearance or decrease in the intensity of the marker band with a decrease in the concentration of the modifier), as well as graphene oxide (separation of the marker lipid band of 1755 cm), inform us about the effect of modifiers on the tissue repair process. The studies also tracked spectral changes identified in serum. Withing the range of the lipid band and the amide I and II bands (α → β conversion), there are clear differences between normal and pathological serum lyophilisates and a sample analyzed from the solution.
Topics: Pregnancy; Female; Humans; Spectroscopy, Fourier Transform Infrared; Placenta; Ascorbic Acid; Oxidative Stress; Biomarkers; Lipids
PubMed: 36257216
DOI: 10.1016/j.saa.2022.121926 -
Journal of AAPOS : the Official... Apr 2023A 5-month-old girl presented with bilateral upper and lower eyelid cicatricial ectropion with right eye exposure keratopathy and bilateral lateral canthal defects....
A 5-month-old girl presented with bilateral upper and lower eyelid cicatricial ectropion with right eye exposure keratopathy and bilateral lateral canthal defects. Physical examination revealed a constriction band over the temporal area of the head and nasal bridge; she was diagnosed with congenital amniotic band syndrome (ABS). Upper and lower eyelid reconstruction procedures were performed along with lateral canthal reconstruction to salvage the remaining left eye. Congenital ABS is a rare disorder. Most cases of ocular ABS are associated with limb deformities due to constriction defects and blood flow restrictions. Our patient presented solely with ocular and periocular deformities.
Topics: Infant, Newborn; Female; Humans; Infant; Amniotic Band Syndrome; Ectropion; Eyelids; Keratoconjunctivitis; Physical Examination
PubMed: 36871930
DOI: 10.1016/j.jaapos.2023.02.001 -
Cellular and Molecular Biology... Feb 2023It was to investigate the value of quantitative fluorescence PCR (QF-PCR) for the selection of specific short tandem repeat (STR) in prenatal diagnosis of fetal...
It was to investigate the value of quantitative fluorescence PCR (QF-PCR) for the selection of specific short tandem repeat (STR) in prenatal diagnosis of fetal chromosomal diseases. Amniotic fluid (AF) and villus samples were obtained from 80 pregnant women at 16-20 weeks of gestation, and venous blood samples were obtained from 60 normal individuals to extract and prepare peripheral blood chromosome, AF cell chromosome, and villus cell chromosome samples for specific STR locus detection. It showed that the area ratio of AMX peak to AMY peak in the Genescan typing map of peripheral blood DNA of normal males was close to 1:1, while the Genescan typing map of peripheral blood DNA of normal females had only AMX peak and no AMY peak. Normal heterozygous individuals had an area ratio between 1 and 1.45 for venous blood, 1.002 and 1.27 for villous samples, and 1 and 1.35 for AF samples. The karyotype of a male fetus was 46, XY, inv [9] (p11: q13), and the structure of fetal chromosome 9 was inverted (interarm), and the site of structural inversion was band 1 in the short breech 1 region and band 3 in the long arm 1 region of chromosome 9. It suggested that QF-PCR can effectively identify the normal human body and cases by selecting specific STR locus detection, which has a good application value for prenatal diagnosis of fetal chromosomal diseases.
Topics: Pregnancy; Humans; Female; Male; Prenatal Diagnosis; Chromosomes, Human, Pair 9; Fetus; Fluorescence; Microsatellite Repeats
PubMed: 37224036
DOI: 10.14715/cmb/2023.69.2.19 -
BMJ Open May 2022To identify any associations between in utero exposure to five over-the-counter (non-prescription) analgesics (paracetamol, ibuprofen, aspirin, diclofenac, naproxen) and...
OBJECTIVES
To identify any associations between in utero exposure to five over-the-counter (non-prescription) analgesics (paracetamol, ibuprofen, aspirin, diclofenac, naproxen) and adverse neonatal outcomes.
DESIGN
Retrospective cohort study using the Aberdeen Maternity and Neonatal Databank.
PARTICIPANTS
151 141 singleton pregnancies between 1985 and 2015.
MAIN OUTCOME MEASURES
Premature delivery (<37 weeks), stillbirth, neonatal death, birth weight, standardised birthweight score, neonatal unit admission, APGAR score at 1 and 5 min, neural tube and amniotic band defects, gastroschisis and, in males, cryptorchidism and hypospadias.
RESULTS
83.7% of women taking over-the-counter analgesics reported first trimester use when specifically asked about use at their first antenatal clinic visit. Pregnancies exposed to at least one of the five analgesics were significantly independently associated with increased risks for premature delivery <37 weeks (adjusted OR (aOR)=1.50, 95% CI 1.43 to 1.58), stillbirth (aOR=1.33, 95% CI 1.15 to 1.54), neonatal death (aOR=1.56, 95% CI 1.27 to 1.93), birth weight <2500 g (aOR=1.28, 95% CI 1.20 to 1.37), birth weight >4000 g (aOR=1.09, 95% CI 1.05 to 1.13), admission to neonatal unit (aOR=1.57, 95% CI 1.51 to 1.64), APGAR score <7 at 1 min (aOR=1.18, 95% CI 1.13 to 1.23) and 5 min (aOR=1.48, 95% CI 1.35 to 1.62), neural tube defects (aOR=1.64, 95% CI 1.08 to 2.47) and hypospadias (aOR=1.27, 95% CI 1.05 to 1.54 males only). The overall prevalence of over-the-counter analgesics use during pregnancy was 29.1%, however it rapidly increased over the 30-year study period, to include over 60% of women in the last 7 years of the study. This makes our findings highly relevant to the wider pregnant population.
CONCLUSIONS
Over-the-counter (non-prescription) analgesics consumption during pregnancy was associated with a substantially higher risk for adverse perinatal health outcomes in the offspring. The use of paracetamol in combination with other non-steroidal anti-inflammatory drugs conferred the highest risk. The increased risks of adverse neonatal outcomes associated with non-prescribed, over-the-counter, analgesics use during pregnancy indicate that healthcare guidance for pregnant women regarding analgesic use need urgent updating.
Topics: Acetaminophen; Analgesics; Birth Weight; Cohort Studies; Female; Humans; Hypospadias; Infant, Newborn; Male; Perinatal Death; Pregnancy; Pregnancy Outcome; Premature Birth; Retrospective Studies; Stillbirth
PubMed: 35504638
DOI: 10.1136/bmjopen-2020-048092 -
Child's Nervous System : ChNS :... Feb 2021Amniotic band syndrome (ABS) has been known since ancient times. Descriptions in modern medicine have occurred since the mid-nineteenth century. The association of the... (Review)
Review
Amniotic band syndrome (ABS) has been known since ancient times. Descriptions in modern medicine have occurred since the mid-nineteenth century. The association of the amniotic band syndrome with tethered cord is rare. It was generally thought to be incompatible with life. Of late, with better imaging, there have been case reports of amniotic bands causing cord tethering in neurosurgical literature, but its association with limited dorsal myeloschisis has hitherto not been described. We report a case of amniotic band syndrome (ABS) associated with a cervical limited dorsal myeloschisis (LDM) in a child of 2 and a half years old. The management of LDM in ABS is essentially the same as in isolated cases.
Topics: Amniotic Band Syndrome; Child; Child, Preschool; Humans; Infant, Newborn; Meningomyelocele; Neural Tube Defects
PubMed: 32519131
DOI: 10.1007/s00381-020-04713-4