Amniotic adhesions

Amniotic adhesions or bands may occur in amniotic band syndrome (ABS)

• ABS is a rare disorder in which bands of mesoderm that emanate from the chorionic side of the amnion and insert on the fetal body can lead to a wide variety of disfiguring and disabling malformations. ABS results in the amputation of fingers or limbs, associated with a wide spectrum of congenital anomalies usually involving the trunk and craniofacial regions including the skull
• ABS is, in general, sporadic, and the incidence is approximately 1 in 15,000 live births
• characterised by a destructive fetal process that is initiated by a rupture of the amnion
  • proposed as a sequela of intrauterine rupture of the amnion, resulting in oligohydramnios and passage of the fetus into the chorionic cavity
  • the fetus subsequently becomes adherent to, intertwined in, and tethered by fibrous mesodermic bands
  • as the fetus grows, its anatomy is distorted. This may lead to cranial or body wall defects or limb abnormalities. Although it primarily affects external structures, there have also been reports of associated malformations of internal structures
• ABS also can include abdominal wall defects with exposed, uncovered viscera
  • specifically, amniotic bands can generate major defects in the abdominal wall with evisceration of thoracic or abdominal organs - these can occur in addition to limb amputations and kyphoscoliosis
  • when evisceration is present with other congenital anomalies, with or without limb anomalies, this is referred to as the body wall complex
    • body wall complex also can be associated with amniotic bands

Reference:

1. Muraskas JKJ et al. Amniotic band syndrome with significant orofacial clefts and disruptions and distortions of craniofacial structures.J Pediatr Surg. 2003 Apr;38(4):635-8.
2. Morovic CG et al.Craniofacial anomalies of the amniotic band syndrome in serial clinical cases. Plast Reconstr Surg. 2004 May;113(6):1556-62