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Amniotic Bands
Published in Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan, Problem-Based Obstetric Ultrasound, 2019
Amar Bhide, Asma Khalil, Aris T Papageorghiou, Susana Pereira, Shanthi Sairam, Basky Thilaganathan
Amniotic bands occur as a consequence of a disruption to the amnion with an intact chorion. In most cases, amniotic bands occur without any associated fetal effects, though occasionally a diagnosis of amniotic band syndrome may be made because of associated fetal anomalies. Amniotic band syndrome is believed to be caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic membrane while in utero. When the amnion ruptures, fetal parts may protrude into the extra-embryonic coelom and the amniotic membrane can entangle various fetal parts, thereby reducing blood supply and causing congenital abnormalities (typically resulting in amputations). Although no two cases are exactly alike, there are several features that are relatively common: syndactyly, distal ring constrictions, shortened bone growth, limb length discrepancy, distal lymphedema, and congenital bands. Very confusingly, by the time amniotic band syndrome is suspected, the amniotic bands are no longer visible, as the fetal insult probably occurred early in the first trimester.
Cranial and Facial Defects
Published in Asim Kurjak, CRC Handbook of Ultrasound in Obstetrics and Gynecology, 2019
Anencephaly, the most common anomaly of the fetal central nervous system (CNS), is characterized by the absence of the brain and cranial vault. Some functioning brain tissue is always present at the level of the brainstem and mesencephalon, and vital functions are therefore present during pregnancy. The defect is covered by a thick stroma membrane, but never by skin or bone. The absence of the cranial vault is readily detected by ultrasound from 12 weeks of gestation. The inability to identify normal brain and bony structures above the orbits is a finding pathognomonic of anencephaly (Figures 1 to 3). A common finding associated with anencephaly is the presence of hydramnios, while oligohydramnios is rarely present. Ultrasound diagnosis is simple and accurate and can be made after a single examination. Differential diagnosis may be of importance in distinguishing between anencephaly and the amniotic band syndrome, which is characterized by partial absence and asymmetry of the cranial vault.
Paediatric radiology
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Ashok Raghavan, Kshitij Mankad, Jeremy B Jones, Neetu Kumar
Amniotic band syndrome results from rupture of the amnion with formation of multiple bands that can cause abdominal wall defects and amputation. Limb-body wall complex is thought to represent a severe form of amniotic band syndrome and results in a large left-sided lateral defect in the abdominal wall.
Fetal Tethered Spinal Cord: Diagnostic Features and Its Association with Congenital Anomalies
Published in Fetal and Pediatric Pathology, 2023
Xiaomei Yang, Shiyu Sun, Yizheng Ji, Yasong Xu, Li Sun, Qichang Wu
Previous studies report that the occurrence of NTD is potentially associated with related syndromes, metabolic disorders, and maternal exposure to harmful substances [17]. Causes of NTD include amniotic band syndrome, limb-body-wall complex malformation, OEIS syndrome, VACTERL syndrome, and other types of spinal abnormalities. VACTERL syndrome, also known as VATER association, was first described by Quan and Smith. This syndrome was named according to the English prefix of the malformed organs. This syndrome was diagnosed in cases with three or more malformations as clinical features [18]. OEIS syndrome, also known as cloacal eversion, is a multi-system malformation characterized by omphalocele, bladder eversion, anal atresia, and spinal abnormalities [17]. From the perspective of embryological development, both VACTERL syndrome and OEIS syndrome are considered to be caused by developmental defects and multiple pathogenic factors in the embryonic mesoderm [19–21]. Previous studies discuss the clear association between lower spine abnormalities and abnormalities in urogenital and colonic structures. It has been widely accepted that this association exists because the caudal neural tube, urogenital system, and anorectal system differentiate during the fourth to seventh week of pregnancy, and the locations of these three systems are very close [22,23]. Kuo et al. [24] report that the frequency of TSC is 86% in patients with VACTERL syndrome and urogenital system abnormalities, indicative of a correlation between TSC and VACTERL syndrome and urogenital system abnormalities.
Free latissimus dorsi flap for upper extremity reconstruction in a 9-month-old
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Ryan D. Wagner, Jacqueline S. Yang, Brittany E. Bryant, William C. Pederson, Shayan A. Izaddoost
A female infant was born at 39 weeks to a 32-year-old mother via in-utero fertilization, with pregnancy complicated by diet-controlled gestational diabetes and oligohydramnios. The patient was noted to have a large full-thickness right dorsal hand and dorsoulnar forearm lesion measuring 4.5 cm × 6.5 cm (Figure 1). Initially, movement in the extremity was unaffected except for mild weakness of extension noted in the thumb and index fingers. A biopsy was unremarkable, and there were no significant radiographic or ultrasound findings. A chromosomal microarray revealed a small duplication on Xq13.2 which was of indeterminate significance after consultation with the Genetics Team. After a multidisciplinary diagnostic approach, neonatal compartment syndrome, amniotic band syndrome, or aplasia cutis were suspected etiologies [12].
Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings
Published in Acta Orthopaedica, 2019
Joachim Horn, Ivan Hvid, Stefan Huhnstock, Anne B Breen, Harald Steen
8 complications occurred that could be solved by surgery without sequelae, and were therefore graded as obstacles according to Paley (1990): in 1 patient (amniotic band syndrome, 40 mm tibial lengthening) autologous bone grafting was required to achieve healing, which occurred within 3 months after that procedure. In 1 patient, an AFN had to be exchanged due to failure of the lengthening mechanism (Precice nail), which was considered to be caused by too extensive hammering during insertion of the nail. 3 patients had to be revised due to migration of locking screws, and 1 patient due to insufficient connection of the receiver in a Fitbone nail. 2 patients sustained femoral fractures due to adequate trauma (fall from bicycle and an accident in a waterfall) 2 and 3 months after consolidation of the regenerate and initiation of full weight-bearing (Figure 5). Both patients were lengthened with RFN, which had not been removed at the time of fracture. Both fractures were treated with open reduction and osteosynthesis with locking compression plates. There were no postoperative infections, and no other problems, obstacles, or complications occurred.