Amniotic band syndrome is synonymous with Amniotic Band Constriction, Amniotic Band Sequence, Congenital Constriction Rings, ADAM (amniotic deformity adhesions mutilations) and Streeter dysplasia. The condition is congenital in nature and is caused due to intrauterine rupture of the amnion. In the developmental process amnion rises up obliterating the extracoelomic space supported by the chorion.

This occurs around 12^th week of pregnancy and sometimes there is some of the extracoelomic space left which leads to the potential space for the amnion to rupture. Once ruptured the remnants of the membrane may form constricting rings around the limbs or can entrap some other fetal part in uterus. There may be amniotic bands and amniotic sheets associated with the pregnancy. Amniotic sheets are the most commonly encountered and are believed to be formed due to the scarring present in the uterus due to previous operative procedure like dilatation and curettage. These sheets may lead to the early labor. These sheets are generally harmless to the fetus. Amniotic bands are less frequently encountered but are of potential threat to the child if formed. They may lead to limb shortening.

Symptoms

• Skull defect
• Amputation of limbs
• Club feet
• Simian crease
• Structural deformities in any part
• Limb anomaly in the fetus
• Visceral defect
• Spine may be affected
• Oligohydramnios
• Kidney cyst
• Other renal abnormalities
• Leakage of amniotic fluid

Complications

• Pulmonary hypoplasia
• Respiratory Insufficiency
• Death
• Fetal compression
• Breech
• Abnormal hand
• Abnormal foot
• Altered facial
• Abnormal facial clefts
• Cleft palate
• Oligohydramnios
• Perinatal morbidity
• Urinary tract abnormalities

Diagnosis and Investigations

Ultrasound during prenatal checkups may reveal various membranes and the fetus sticked to the membranes with no movement at all but the membranes can be seen in various conditions like extra amniotic pregnancy and may be extra membranes of amnion.

Treatment and Medications

• As the condition develops in utero so no medical treatment is available for the condition but one can restrict taking some medications which can lead to the rupture of the amniotic membrane like cocaine, mifepristone etc.
• If the bands are compromising the blood circulation of the limbs or the fingers or other distal parts then a band excision surgery is advised.
• In some cases however early amputation is mandatory
• Conditions like club feet and cleft palate will require the reconstruction surgery
• If the bands are identified in the ultrasound then fetoscopic surgery can be performed
• Hard bands compromising the blood and lymph circulations are excised at the time of the birth.