What is amniotic girdle syndrome?
Amniotic girdle syndrome is a condition in which a portion of the amniotic membrane ruptures to produce fibrous bundles or sheaths, causing the embryo or fetus to be bound, compressed, or entangled with the amniotic girdle. The entanglement of the amniotic girdle affects the blood supply to the affected parts, especially the limbs, resulting in a variety of malformations. The incidence of amniotic band syndrome is 7.8:10,000 in relation to the number of live births.
Manifestations of amniotic girdle syndrome
Depending on the severity of the amniotic girdle, the consequences are cosmetic as well as functional. For the limbs, the main manifestations are
complete or partial defects of the fingers and toes, or short deformities of the fingers and toes.
l Short fingers (toes) and syndactyly (toes)
l Defects of the upper or lower extremities.
l Circumferential fasciculations of the fingers and toes, upper extremities, or lower extremities.
l Edema or swelling of part of the limb.
l Shorter than normal limb on one side.
Causes of amniotic girdle syndrome
The exact etiology is not known. Current studies suggest that the amniotic membrane is fragmented into slender fibrous bands that float in the amniotic fluid. These amniotic bands easily wrap around the limb, and as the embryo grows, the bands gradually compress the limb and affect the blood supply, resulting in impaired development or even necrosis of the limb. The necrotic tissues adhere to each other and develop syndactyly.
Risk factors associated with the development of amniotic girdle syndrome
First pregnancy
Smoking or drug use during pregnancy
Injury to the abdomen during pregnancy
having a chorionic villus sampling (CVS) test
Have used a drug called misoprostol – misoprostol to help induce labor or abortionProblem pregnancies
Is it possible to prevent amniotic girdle syndrome?
There is no effective way to prevent amniotic girdle syndrome because the exact cause of amniotic girdle syndrome is not known. However, reducing the risk factors associated with amniotic banding may reduce the likelihood of amniotic banding syndrome.
How is it diagnosed?
During pregnancy: Diagnosis can be made as early as 12 weeks of pregnancy by ultrasound.
Physical examination, which allows for a basic definitive diagnosis.
X-rays: can interpret the skeletal condition.
MRI: to determine the neurovascular damage.
Treatment of amniotic girdle syndrome
Mild cases can be treated without any treatment, while severe cases of fasciculation syndrome require long-term and repeated treatment. The main components include
band release
separation of the juxtaposed fingers
Stump revision
Intrauterine surgery: For severe girdle syndrome affecting the limbs, intrauterine surgery may be considered.
Prognosis of girdle syndrome
The outcome of treatment depends on the site of involvement, the severity, the duration of treatment, and the method of treatment.