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The Amniotic Band Syndrome

From the Birth Defects Clinic, Department of Pediatrics A and Pediatric Research Department, the Department of Obstetrics and Gynecology and the Department of Pathology at the Kaplan Hospital, Rehovol, Israel, affiliated with The Hebrew University and Hadassah Medical School, Jerusalem, and the Laboratory of Developmental Pathology, J. Casper Department of Pathology, Beilinson Hospital, Tel-Aviv University Medical School, Petah-Tikva, Israel

Abstract

Amniotic fibrous bands may attach to various parts of the fetus or newborn and cause a variety of congenital malformations. The incidence has been estimated at approximately 1:5000 to 1:10,000 pregnancies. A case is reported in which a young, healthy woman gave birth to a premature infant, with intrauterine amputation of the left arm, and mummification and atrophy of -the still adherent distal part of the affected limb. Intrauterine amputation of the right middle finger was also found. The fetal side of the placenta revealed fine fibrous threads and bands. Two main theories of the pathogenesis of amniotic bands have been proposed: 1) the amniotic bands are the result of developmental defects occurring at the time of the formation of the germ disk and the amniotic cavity (endogenic origin), and 2) these bands generate from early rupture of the amnion (exogenic origin). Careful examination of the placenta is essential for a precise definition of the pathogenesis.