Amniotic Band Syndrome

Amniotic Band Syndrome

Article
Bone, Muscle, & Joint
Women's Health
+3
Contributed byKashif M.Mohiuddin, MD, FRCPath+1 moreJun 29, 2020

What are the other Names for this Condition? (Also known as/Synonyms)

  • ABS (Amniotic Band Syndrome)
  • TEARS (The Early Amnion Rupture Spectrum)
  • The Early Amnion Rupture Spectrum (TEARS)

What is Amniotic Band Syndrome? (Definition/Background Information)

  • In Amniotic Band Syndrome (ABS), fibrous bands from the amniotic membrane of the placenta constrict fetal growth during pregnancy. It can constrict blood flow to the developing baby and cause a range of signs and symptoms
  • The placenta is an organ that connects the developing fetus to the uterine wall. It is a disc shaped reddish brown structure that connects the fetus to the mother through the umbilical cord. The umbilical cord contains two umbilical arteries and one umbilical vein
  • The normal function of placenta is to supply nutrients and oxygen to the fetus from the mother’s blood and remove wastes from the fetal body
  • The developing fetus is affected depending on which part of the body the amniotic band wraps. In case the band wraps around a developing limb, it can result in amputation of the limb, in extreme cases. Due to this, a baby at birth may have a missing toe, finger, or even a missing arm or leg
  • There are no risk factors or causative factors associated with Amniotic Band Syndrome
  • There is no definitive treatment available for Amniotic Band Syndrome; however, surgery can help correct some of the associated deformities
  • The prognosis of Amniotic Band Syndrome depends upon the extent of abnormalities; in some cases, the prognosis is poor
  • Presently, Amniotic Band Syndrome is a condition that cannot be prevented

Who gets Amniotic Band Syndrome? (Age and Sex Distribution)

  • Amniotic Band Syndrome can occur in pregnant women of all ages
  • 1 in 2,500-10,000 deliveries at full-term may show ABS with varying severity
  • There is no racial, ethnic, or geographical predilection observed

What are the Risk Factors for Amniotic Band Syndrome? (Predisposing Factors)

  • Currently, no risk factors have been identified for Amniotic Band Syndrome
  • It is reported that prior uterine surgery may be a risk factor for ABS
  • Research is being performed to identify the relevant risk factors

The presence of ABS in one pregnancy does not indicate that the condition may occur in subsequent pregnancies.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Amniotic Band Syndrome? (Etiology)

  • The exact cause of Amniotic Band Syndrome is currently unknown
  • Abnormal fibrous bands from the amnion constricting the growth of the developing baby are the cause of Amniotic Band Syndrome. The constricting bands occur as a developmental abnormality
  • Researchers have established that ABS is not a genetic condition

Amniotic Band Syndrome is not caused by what the expectant mother does or does not do, either prior to or during pregnancy.

What are the Signs and Symptoms of Amniotic Band Syndrome?

The signs and symptoms of Amniotic Band Syndrome vary. It depends upon which part of the body the amniotic band wraps, while the baby develops in the womb.

  • If the band wraps on a limb (arm or leg) or part of a limb (toe or finger), it may result in the amputation of the limb or digit
  • If the band is on the face region, it can cause facial abnormalities including cleft lip and cleft palate
  • If the band wraps around the umbilical cord that supplies blood and nutrition to the developing baby, it can cause intrauterine growth retardation (IUGR). In severe cases, this may lead to fetal death
  • Deformities may be observed in the finger and finger nails, toes and toenails
  • Presence of webbed digits (syndactyly)
  • Either arms or legs may be of varying lengths
  • Swelling of the joints
  • Children with ABS may have an associated clubfoot, club hand, and hemangiomas
  • Congenital band indentations: The baby may be born with deep indentations in various parts of the body caused by the pressure (constriction) of the amniotic band

How is Amniotic Band Syndrome Diagnosed?

The diagnosis of Amniotic Band Syndrome may include:

  • Physical examination along with an evaluation of one’s medical history
  • Fetal ultrasound during pregnancy may show abnormally developing fetus. However, It is difficult to detect small amniotic bands on an ultrasound scan during pregnancy
  • MRI scan of the developing fetus may be helpful

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Amniotic Band Syndrome?

The complications of Amniotic Band Syndrome depend upon where the band forms.

  • It can cause a variety of congenital abnormalities
  • ABS can lead to intrauterine growth retardation, which in severe cases may result in miscarriages or stillbirths
  • A child with severe deformities can cause serious emotional distress to the parents

How is Amniotic Band Syndrome Treated?

Currently, there is no specific treatment available for Amniotic Band Syndrome.

  • Removing the amniotic band during pregnancy (in utero surgery) can be attempted. The type of surgery depends on the type of abnormality of the baby (after birth) and may include:
    • Surgical repair of webbed fingers and toes
    • Surgical treatment of cleft lip and palate
    • Correcting clubfoot, which can occur in about one-third of the babies born with ABS
  • Since the condition is associated with an increased risk of fetal death, it needs careful monitoring and regular follow-ups during the antenatal period
  • In many cases, the condition is diagnosed after the birth of the child

How can Amniotic Band Syndrome be Prevented?

  • Currently, there are no definitive methods available to prevent Amniotic Band Syndrome
  • Prenatal monitoring using fetal ultrasound may help detect the condition early. This can help the healthcare provider to have better treatment options and aid in minimizing the impact of Amniotic Band Syndrome

What is the Prognosis of Amniotic Band Syndrome? (Outcomes/Resolutions)

  • The prognosis depends on the severity of the findings. In minor cases, the prognosis of Amniotic Band Syndrome is excellent. Nevertheless, ABS is responsible for 2% of the fetal deaths
  • In cases where there are severe deformities, the outcome can be poor. Also, a severe constriction of the umbilical cord by the amniotic band may result in grave prognosis including miscarriage and stillbirth

Additional and Relevant Useful Information for Amniotic Band Syndrome:

The following DoveMed website link is a useful resource for additional information:

 https://www.dovemed.com/diseases-conditions/pregnancy-related-disorders/

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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Kashif M.Mohiuddin, MD, FRCPath picture
Reviewed by

Kashif M.Mohiuddin, MD, FRCPath

Pathology, Medical Editorial Board

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