During pregnancy, a fetus is well protected in the amniotic sac surrounded by the amniotic fluid. The baby derives its nutrients from the amniotic fluid, cushions against infections and physical harm. Did you know that damage to the amniotic sac can endanger the baby? Are you aware of Amniotic Band Syndrome?
When the amniotic sac suffers damage during pregnancy, it is known as Amniotic Band Syndrome (ABS). The damage to the amniotic sac causes string-like strands of tissue. These strands can wrap themselves around the developing baby and restrict or completely cut off the blood flow to certain parts of the baby’s body.
When the baby does not get sufficient uninterrupted blood flow during pregnancy, it can lead to congenital disabilities. The severity will depend on where these bands are and which part of the baby’s body they affect.
Amniotic Band Syndrome is also known as Amniotic Band Disruption, Amniotic Band Sequence, Constriction Ring Syndrome, and ADAM complex.
There is no clear or specific cause for Amniotic Band Syndrome. Many researchers think it may not be genetic, and damage to the amniotic sac lining during pregnancy could lead to this scenario.
The amniotic bands are thin strands of tissue that may not be visible in an ultrasound or any routine pregnancy imaging. So, in most cases, ABS is discovered only during the baby’s birth.
Can an ultrasound detect amniotic band syndrome? A scan can reveal if the ABS is severe, leading to malformation of limbs in the baby.
Some tests your doctor might use to diagnose the condition are:
The impact of ABS on the baby depends on where the bands are, which parts of the baby’s body they are wrapped around, and how tightly they are wrapped. Usually, these bands
restrict blood flow to the baby’s limbs, toes, or fingers. In some cases, the bands can also wrap around the baby’s head, neck, vital organs, or even the umbilical cord.
If the bands are not tightly wrapped around any body part, it may cause just some skin indentation in the baby. Sometimes, when these bands wrap around the baby’s limbs, it can lead to clubbed feet, cleft palate, fused fingers or toes, or other complications. In severe cases, it can lead to deformed limbs in the newborn, congenital amputation, or a total block in the blood supply to the baby. This can become very dangerous.
If an ABS diagnosis happens during the pregnancy, the doctors closely monitor the pregnancy and the baby’s development. Regular ultrasounds will help detect possible problems or risks immediately and take appropriate steps to care for the baby.
Sometimes, in case of severe constriction of blood supply, the baby may need corrective surgery or other medical treatments. These are usually done after the baby is born. Mild congenital disabilities may not need treatment. These can be determined only after the birth of the baby.
Postnatal treatments for babies with ABS are:
Some babies may require corrective surgery immediately after birth, while others may not need it until later. Plastic surgery or reconstructive surgeries help rectify the deformities to an extent, but they may not be done for a few years. The doctors will give the baby some time to grow before they can perform such surgeries.
Severe ABS may restrict the blood flow to one or more limbs completely. In such cases, the baby might lose the limb, thus requiring a prosthesis. A prosthesis is an artificial device that replaces the missing body part like a limb. Today, advanced technologies, including 3D printing, can help in this area. Babies can regain their limb function when they are 12 or 18 months old.
If the damage caused by ABS is mild, it might affect the functioning of the limb only to a certain extent. In such cases, rehabilitative therapies can help babies regain the strength and function in their limbs. The exact type of therapy, the time required and the extent of functioning recovered varies from case to case. It all depends on how severe or mild the impact of ABS was on the baby’s development.
If the imaging tests during pregnancy show severe ABS impact, the doctors might have to intervene in utero. This means they will undergo corrective surgery before the baby’s birth while still in the mother’s womb. Foetoscopic Amniotic Band Resection is a minimally invasive procedure that helps cut the amniotic band or bands restricting the blood supply by using a tiny instrument with a camera at the end. With the guidance of an ultrasound, the doctor will insert this instrument through the mother’s abdomen to reach the foetus and cut the bands, thus restoring the blood supply.
This surgery carries some serious risks. An experienced doctor and a detailed discussion with them are essential to understand the pros and cons before deciding on the procedure.
Amniotic Band Syndrome is a rare complication in pregnancy. Regular ultrasounds help track the pregnancy and ensure such issues are handled immediately
It is caused by damage to the amniotic sac, which forms string-like strands of tissues that can wrap around the baby.
In case of mild ABS, there will be no symptoms and the bands are discovered only during the baby’s birth. In severe cases, ultrasounds can reveal a restriction in the blood flow or deformity in the baby’s body. This can happen anytime in the second or third trimester of the pregnancy.
It depends on where the bands are and which part of the body is not getting blood supply. If the blood to the umbilical cord or vital organs is restricted, it can be fatal. If the blood flow to the limbs is constricted, treatment and surgery can help.
According to the American Journal of Obstetrics and Gynecology, foetoscopic resection has a survival rate of 83%, and 80% of the cases with ABS had normal development after birth.
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