TOPIC ABOUT AMNIOTIC BAND STNDROM

1. Othopedic departement A Pr.BENHABILES
Presented by:
Dr.HAMHOUM

2.  DEFINITION
 INCIDENCE
 CAUSES
 DIAGNOSIS
 SYMPTOMS
 TREATMENT
 Z-PLASTY
 SYNDACTYLY TREATMENT
 CLUB FOOT TREATMENT
 FOLLOW-UP
 EXAMPLE
 CONCLUSION
 REFERENCES

3.  Amniotic band syndrome, also known as
constriction ring syndrome, happens when
fibrous bands of the amniotic sac get tangled
around a developing fetus.

4.  ABS can prevent body parts from developing
normally, leading to birth defects (congenital
disorders).
 Sometimes it causes body parts to amputate,
or separate from the fetus.
 Amniotic bands can also cause a fetus to die
in the uterus if blood can’t get to vital organs.

5.  ABS is rare. It occurs in about 1 out of every
1,200 to 15,000 live births.
 The cause of amnion tearing is uncertain and
is consider a chance event.
 It does not appear to be genetic or hereditary,
so the likelihood of it occurring in another
pregnancy is not common.

6.  ABS is rare. It occurs in about 1 out of every
1,200 to 15,000 live births.
 The cause of amnion tearing is uncertain and
is consider a chance event.
 It does not appear to be genetic or hereditary,
so the likelihood of it occurring in another
pregnancy is not common.

7.  There are two main theories about the cause
of ABS.
 The amnion membrane
becomes damaged,
this causes bands of
tissue from the amnion
to come loose in uterus.

8.  The bands may wrap around the body parts
of a fetus. These bands can tighten and keep
blood from getting to the fetus’s body parts,
usually the arms or legs.
 Causes of amniotic sac damage may include:
 Drugs such as misoprostol
 Prenatal tests such as amniocentesis
 Open fetal surgery

10.  But in some cases of ABS, the amniotic sac
remains intact and undamaged. So other
experts believe ABS is the result of circulation
(blood flow) problems in the fetus.

11.  The amniotic bands are difficult to identify on
a regular ultrasound and thus, ABS is usually
diagnosed at delivery.

12.  Anatomy ultrasound may be not able to
identify the bands as the individual stands are
small and hard to see but only see the results
of the fusion such as missing or deformed
limbs and measure blood flow.

13.  3D ultrasound and MRI to check the severity
of constriction and anomalies.
 Fetal echocardiography to examine the baby's
heart structure and function

14.  Sometimes ABS is mild and only restricts
blood flow to the surface of the skin.
 Most cases (about 80%) involve the hands or
feet.
 However, the location of the band determines
which area is affected. Deep blood flow
constriction may lead to:

15.  Constriction rings in the skin.
 Missing fingers, toes or limbs.

16.  Acrosyndactyly ,syndactyly (webbing or fusion
between fingers or toes).
 Bone deformities, including kyphosis,
scoliosis or lordosis.

17.  Head and face deformities, such as cleft lip
and palate.
 Openings or defects in the abdomen or chest.

18.  Encephalocele (openings in the skull).
 Microphthalmia (small or underdeveloped
eyeballs).

19.  Clubfoot.
 ABS often causes a premature birth which can
have its own risks.

20.  The affected body parts and functions
determine the treatment for ABS.
 Mild cases of ABS may only need careful
monitoring by a healthcare provider.
 But severe ABS that affects organ function
needs immediate treatment.

21.  Treatment usually occurs after birth where plastic
and reconstrictive surgery is considered to treat
the resulting deformity.
 children with missing or shortened limbs may
benefit from prosthetics (artificial body parts).
 Physical and occupational therapy may be needed
long term.
 But these procedures can be performed electively
at a later time

22.  In rare cases ,if diagnosed in uterus ,fetal
surgery may be considered to save a limb
which is in danger of amputation or other
deformity.
 Surgical treatment depend on the medical
stability of the child and the neurovascular
status of the limb.

23.  Surgical treatment is indicated for patients
with constriction rings in the skin ,syndactyly
acrosyndactyly that compromises hand
function,club foot.
 Surgical correction of ABS involves removing
constrictive tissue and rearranging the skin
using many techniques such as the z plasty

24.  Z plasty is a versatile surgical technique that
is extensively used to lengthen the
constriction and thus correct the deformity
and improve the function.

26.  The main goal of the treatment in syndactyly
is to seperate fused digits creat a normal web
space and improve both function and
esthetics of the normal hand

27.  The accepted method of treating clubfeet is
by the Ponseti method of Serial Plaster
Casting.Treatment should be started right
away.The initial treatment consists of
manipulating the foot to get it to the best
position possible,
and then holding
the correction in a
cast.

28.  All patients with ABS should be monitored
regularly until skeletal maturity is reached,
because of the potential for recurrence of the
rings and for secondary contractures that
may develop.
 For patients with acrosyndactyly,hand
function is limited secondary to stiffness of
the joints,but reconstruction can result in
good prehension and grasp.

29.  In our case , it’s a infant aged 13 months who
has an amniotic band syndrome whose
symptoms are:
 Constriction rings in the skin.
 Missing toes.
 Clubfeet .

31.  Amniotic band syndrome (ABS) occurs when
loose bands of tissue in the uterus entangle a
developing fetus. The bands prevent blood
from getting to the fetus’s body parts.
 ABS can lead to serious birth disorders or
even death.
 Treatment usually includes surgery,
prosthetics (artificial body parts) and
rehabilitation.

32.  Cignini P, Giorlandino C, Padula F, Dugo N, Cafà EV, Spata
A. Epidemiology and causes of amniotic band syndrome, or
ADAMsequence (https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C3530965/). Journal of Prenatal Medicine. 2012 Oct-
Dec;6(4):59-63. Accessed 10/21/2022.
 Genetic and Rare Diseases Information Center. Amniotic band
syndrome (https://rarediseases.info.nih.gov/diseases/429/amni
otic-band-syndrome). Accessed 10/21/2022.
 National Organization for Rare Disorders. Amniotic Band
Syndrome (https://rarediseases.org/rare-diseases/amniotic-
band-syndrome/). Accessed 10/21/2022.
 Plastic and Reconstructive Surgery - Global Open 8(5):p e2842,
May 2020.
 Pediatric Orthopaedic Society of North America. Amniotic Band
Syndrome (https://posna.org/Physician-Education/Study-
Guide/Amniotic-Band-Syndrome). Accessed 10/21/2022.