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Amniotic band syndrome (ABS) develops when the lining of the amniotic sac becomes injured during pregnancy. This produces string-like strands of tissue in which the fetus becomes bent. These strands (called amniotic bands) can wrap around various areas of the growing body. This stops (constricts) blood flow and prevents the fetus from growing normally. Constricted blood flow causes a variety of birth abnormalities. They can range from minor to severe deformities, limb loss, or life-threatening complications.

ABS is also referred to as amniotic band disruption, amniotic band sequence, constriction ring syndrome, and ADAM complex, among other terms.

How Does ABS Affect My Baby?

The presence and severity of birth abnormalities are determined by the location and tightness of the amniotic bands. The bands typically constrain the limbs, fingers, and toes. They may also wrap around the fetus' head, neck, umbilical cord, or essential organs.

Some babies may just have skin indentations. Others may be born with clubfeet, fused fingers or toes, a cleft palate, or other physical abnormalities. In the most extreme cases, severe constriction can result in congenital amputation (missing limbs) or a blocked blood supply. This might be fatal.

How is Amniotic Band Syndrome diagnosed?

ABS is typically diagnosed at delivery since the amniotic bands are difficult to detect on a standard ultrasound. However, in some situations, anomalies, such as limb deformities, might be observed. If your doctor suspects ABS, they may refer you to a fetal clinic for further testing and treatment.

  • Other diagnostic tests could include:
    • Anatomy ultrasound - To confirm the diagnosis, determine the location of the bands and measure blood flow.
    • MRI - To determine the severity of constriction and anomalies.
    • Fetal echocardiography – Examine the baby's heart anatomy and function.

    How is ABS monitored and treated?

    Once ABS is diagnosed, your doctors will closely monitor both your pregnancy and your baby's growth and development. Regular ultrasounds will help you and your medical team identify changes, dangers, and potential problems, allowing you to establish a treatment plan.

  • Treatments after the baby is born include (postnatal):
    • Surgery – Babies may require surgery immediately after delivery or later in life. When necessary, emergency surgery is performed to loosen the restricting bands. Plastic and reconstructive surgery to treat defects may take months or even years. This allows the baby time to develop.
    • Physical or Occupational Therapy – Some newborns will undergo rehabilitative therapies to improve their strength and function. The sort of therapy used is determined by the type of birth defect.
    • Prosthetics – Children who have lost a limb may receive a prosthesis. A prosthesis is an artificial device that replaces a lost body part. 3-D printing and other technologies have significantly enhanced these gadgets. They can help youngsters regain limb function as young as 12 to 18 months of age.

    Sometimes, however, ABS cause severe or life-threatening damage that must be corrected before the baby is born. For example, an amniotic band could be wrapped around the umbilical cord or cutting off blood circulation to a limb. In certain circumstances, fetal surgery could be an option. When in-utero intervention is required, a minimally invasive surgery known as fetoscopic amniotic band excision is typically used. A skilled surgeon utilizes ultrasound-guided imaging to reach the fetus through the mother's abdomen with a tiny device (equipped with a camera). The surgeon then cuts the band or bands to relieve constriction and prevent additional injury, such as loss of life or limb. It is critical, however, to make an informed decision and recognize that this procedure includes significant risks. These hazards include preterm birth, hemorrhage, and fetal harm.

    How Will ABS Affect My Baby's Long-Term Health?

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    Everyone has varied long-term outcomes. They are usually determined by the body parts involved and the severity of the disease. The greatest outcomes typically involve limbs and birth abnormalities that can be surgically corrected or treated with therapies that restore function without affecting general health. In the most severe situations, ABS can result in permanent or life-threatening complications.

    Dr. Neeraj Godara is considered one of the best Hand,Wrist ,Foot & Ankle Reconstructive & Microsurgeon.He can provide an accurate diagnosis and recommend appropriate treatment options based on your individual needs. Reference: https://www.nationwidechildrens.org/conditions/amniotic-band-syndrome