Amniotic Band Sequence: A Case Report

Background: Amniotic band sequence (ABS) is a rare condition in which parts of a fetus get entangled by the amniotic bands attached to the fetal surfaces and structures. This can lead to grotesque structural fetal anomalies or constriction rings that appear in-utero. The severity of this condition ranges from visceral herniation or mild constriction to complete amputation of a digit or limb. This anomaly affects one infant out of 11,200 and this number has shown a stable trend during the last 17 years. Management of this condition is individualized and can include Z-plasty, W-plasty and other such cosmetic surgeries for mild conditions. Severe conditions may require neurovascular reconstruction and even amputations.

The Case: This paper reports a 6-month-old female who presented with constriction rings on both lower limbs and on the upper left limb. She was the youngest of 3 siblings, none of which presented with amniotic band sequence at birth. The child was of an African descent and was born in Tanzania to parents of a standard economic class. The condition was observed at birth and not in-utero. The baby was brought to a tertiary care hospital in Mumbai, India where she underwent Z-plasty surgery. The baby has now recovered from the surgery and appears to be in good shape.

Conclusion: The etiology of the amniotic band sequence is still not clear. The mother of the patient provided a history free from illnesses or abnormal discomfort during the term of the pregnancy. Identification of this anomaly in the pre-natal periods is very important as one can initiate preventive measures. Prenatal ultrasonography is the only screening method to diagnose these deformities.