Every expectant mum hopes that their little bundle of joy sees the light of the world safe and growing healthily. However, aside from infections and hereditary diseases, other developmental issues, called congenital defects, can still occur along the way. In this article, we discuss a rare defect called Amniotic Band Syndrome (ABS) – from causes to how to prevent amniotic band syndrome.
Here’s what every expectant mother should know about this condition.
What Is Amniotic Band Syndrome (ABS)?
Amniotic band syndrome or ABS is a condition which occurs when you are still pregnant.
When the baby is in your womb, it is encapsulated in your amniotic sac, which contains the amniotic fluid. The amniotic fluid keeps the baby afloat.
Interestingly, the amniotic sac containing the baby and fluid has two films which stick together. The exterior film, which faces the uterus, is the chorion, whereas the inner film surrounding the baby is the amnion.
How to prevent amniotic band syndrome? A diagram showing how ABS occurs. | Image Source: University of San Francisco
Amniotic band syndrome affects an unborn baby when the amnion tears abruptly but without damage to the chorion.
Parts of the amnion then hang loosely, like thin threads inside the amniotic sac.
These amniotic bands can then accidentally twist and wrap around different body parts of your baby, which can affect your little one in many ways.
Depending on which body part is entangled and whether it is bound tightly, blood flow could be constricted and impact your little one’s development.
These birth defects include:
- Missing limbs or digits. A band that twists around a limb tightly can lead to its amputation, such that the baby lacks fingers and toes or may be born with a partial arm or leg. The baby is sometimes born with dead limbs that need to be removed surgically.
- Cleft lip or palate if the band goes across the baby’s face.
- Clubfeet, which commonly happens with babies suffering from ABS.
- In the worst-case scenario, fetal death. If the amniotic band twists onto the umbilical cord, it cuts off the blood supply. This presents a risk of miscarriage.
Is Amniotic Band Syndrome Serious?
Doctors assess amniotic band syndrome on a case-to-case basis. Its severity is influenced by where the bands have wrapped around the baby and how tight they are.
ABS can be mild or quite severe. However, this condition does not harm the pregnant mother in any way. Many issues arise after the mum has given birth and affect the baby.
A variety of other names, also known as Amniotic Band Syndrome are:
- amnion rupture sequence
- amniotic bands
- congenital constriction rings
- constriction band syndrome
- Streeter bands
- Streeter dysplasia
- limb body wall complex
- amniotic band sequence
- amniotic deformity, adhesions, mutilations (ADAM) Complex
- Streeter anomaly
What Causes Amniotic Band Syndrome?
Image source: iStock
Amniotic band syndrome is relatively rare, ranging from 1 case in 1,200 to 1 case in 15,000 live births. It is hard to study because it is so rare. It happens totally by chance and is not genetically inherited. Thus, one baby affected by ABS won’t affect another baby.
This condition is also not linked with anything you did or did not do during pregnancy. So if you’re asking yourself, “How to prevent amniotic band syndrome?” there is no clear answer.
Recent research hasn’t even pinpointed an exact cause or prenatal factors for ABS. Some small-scale studies have established links with the issues below, but researchers still need further studies to pinpoint the cause of ABS.
- Previous surgery of the Uterus
- Chorionic Villus Sampling (CVS) is a test which extracts the chorionic villus for genetic tests. Researchers suspect the needle puncturing the chorion could also cause the amnion tears.
- Pregnant women with exposure to Misoprostol, a drug that triggers abortion
- Smoking and drug use while pregnant
What Are the Symptoms of Amniotic Band Syndrome?
In general, amniotic band syndrome can cause many problems, ranging from mild issues to complicated or even fatal ones.
Here’s a short list of how ABS could affect your baby:
- Tightening or partial loss of fingers and toes, with some not fully developing
- Tightening or partial loss of arms and legs, with some not fully developing
- A large swollen area after the band is located
- Club hands or club feet (hands or feet that are twisted and turned inwards)
- Cleft lip and/or palate (a crack in reaching from the lip towards the nose)
- Facial deformities
- Spinal deformities
- Thoracoschisis (tightening of the thoracic wall)
- Abdominal wall disorders
- Encephalocele (an abnormality defined by the brain tightly poking out of the skull)
- Anencephaly (an abnormality defined by the absence of parts of the brain and skull, leading to little or no forehead at all)
- Tightening of the umbilical cord (blood supply from the mum goes through the umbilical cord and tightening it leads to blockage of the baby’s blood supply)
- Limb-body-wall complex (combination of a problem involving the limbs and typically the chest or abdomen of the baby)
How to Diagnose ABS
Doctors can diagnose ABS before the baby is born or, more commonly, after he is born.
Pre-birth diagnosis
Experienced doctors or specialists might be able to pinpoint ABS accurately based on an ultrasound scan. Doctors normally perform this scan in the baby’s 12th week in the womb.
If the doctor suspects the baby has ABS, discuss this with an experienced specialist.
Amniotic bands are minute in size and very difficult to see, even with ultrasound. This often leads to misdiagnosis. An expert in ABS can guide you with their professional opinions on what the ultrasound scan might mean.
Post-birth diagnosis
Once you have given birth, there are several ways your doctor can assess whether your baby has ABS or not, such as:
- A physical examination. Your doctor will look for deformed limbs or any other physical abnormalities with your baby.
- An X-Ray to assess how deeply an amniotic band might have impacted the tissues below the skin
- Magnetic Resonance Imaging (MRI) or other scans to further understand how the amniotic band could have influenced or injured blood vessels and nerves
- Other deeper tests such as targeted ultrasound (3D), Doppler Blood Flow Study or a Fetal Echocardiogram
How to Prevent Amniotic Band Syndrome?
Image Source: iStock
Unfortunately, there isn’t a definite method proven to prevent ABS. Although ABS may arise due to CVS, it is still an unlikely cause of ABS.
It’s important to know that there is no way to prevent Amniotic Band Syndrome, but there are steps you can take before and during pregnancy to reduce its risk.
First, ensure you get regular prenatal care and check-ups with your healthcare provider. This will help ensure that any issues are detected early on, so they don’t lead to complications later in the pregnancy.
Second, talk with your doctor about your family history so they can help you identify any potential risk factors. Suppose anyone in your family has had a miscarriage or other complication related to amniotic bands. In that case, you need to be extra careful about getting proper nutrition and exercise and keeping tabs on any unusual symptoms throughout your pregnancy.
What Should I Do if Doctors Diagnose My Baby With Abs?
After your doctor thoroughly examines your baby’s condition, he will discuss potential treatment options. Fetal surgery will likely be recommended for extreme cases, whereas mild cases may be treated with reconstructive surgery after giving birth.
In general, there are a variety of treatment options for ABS:
- Supportive therapy targeted at alleviating the symptoms (for instance, oxygen or breathing support for babies with improperly developed lungs)
- Reconstructive or plastic surgery for developmental abnormalities, such as webbed fingers or feet and cleft lip
- Clubfoot treatment via the Ponseti method
- Occupational therapy so that the children can practice, and master, using their recovered fingers, toes, arms and legs
- 3D-printing prosthetics to replace the abnormally formed limbs
- Fetal surgery, for really extreme cases of ABS in unborn babies. Fetal surgery involves severing the amniotic bands via a laser or sharp surgical apparatus while the baby is still in the amniotic sac. Normally, consideration is given before choosing this option, as there may be further complications afterwards.
If your child has ABS, you will have many opportunities to discuss what surgeries you need to know about and how to manage his or her life better. Remember, if you have any concerns, always consult a medical professional.
Updates from Pheona Ilagan
amnioticbandsyndrome.com, University of San Francisco, rarediseases.org, Very Well Family, Seattle Children’s Hospital, 123radiology
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