- •Bands in amniotic fluid appear as thin echogenic strands attached to the defect and usually connect to the uterine wall. It is important to note that visualization of bands is not required to suggest the diagnosis.4Random anomalies that do not follow a pattern should lead to suspicion for amniotic band sequence (Figure 1).
- •Constriction ring defects of the extremities typically are present.7,8These usually involve fingers or toes with or without edema of a distal extremity.4These constriction rings can lead to amputation of limbs or digits and the appearance of syndactyly on ultrasound imaging (pseudosyndactyly) [Figure 2].
- •Craniofacial deformities can include single orbital involvement, severe clefts that do not conform to a pattern of developmental clefts, severe nasal deformity, or asymmetric encephaloceles.4,9,10
- •Chest wall and abdominal wall defects can occur but are less common. Examples include ectopia cordis, gastroschisis-like bowel herniation, omphalocele-like liver herniation, and bladder exstrophy.
- •Body stalk anomaly: Fetal abdominal wall adherent to placenta, short umbilical cord, no cranial or limb defects, no evidence of fibrous bands
- •Specific craniofacial defects or abdominal wall defects: Typically isolated and can cause specific functional abnormalities that are associated with embryologic development
- •Amniotic sheets: Amnion wrapped around synechiae and a structurally normal, mobile fetus; importantly, amniotic band sequence should not be diagnosed in the absence of fetal abnormalities.
- •Chorion-amnion separation: No entrapment of fetal parts, no associated bands
Pregnancy and Delivery Management
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- Amniochorionic mesoblastic fibrous strings and amnionic bands: associated constricting fetal malformations or fetal death.Am J Obstet Gynecol. 1965; 91: 65-75
- The amniotic band disruption complex: timing of amniotic rupture and variable spectra of consequent defects.J Pediatr. 1979; 95: 544-549
- Diagnostic imaging: obstetrics.3rd ed. Elsevier, Philadelphia2016
- Prenatal diagnosis of amniotic band syndrome: risk factors and ultrasonic signs.J Matern Fetal Neonatal Med. 2015; 28: 281-283
- Epidemiology of the early amnion rupture spectrum of defects.Am J Dis Child. 1988; 142: 541-544
- Congenital transverse defects of limbs and digits (‘intrauterine amputation’).Arch Dis Child. 1962; 37: 263-276
- A pattern of craniofacial and limb defects secondary to aberrant tissue bands.J Pediatr. 1974; 84: 90-95
- 3D/4D sonographic evaluation of amniotic band syndrome in early pregnancy: a supplement to 2D ultrasound.J Obstet Gynaecol Res. 2011; 37: 656-660
- 3D and 4D sonographic imaging of amniotic band syndrome in early pregnancy.J Clin Ultrasound. 2008; 36: 573-575
- “ADAM complex” (amniotic deformity, adhesions, mutilations): a pattern of craniofacial and limb defects.Am J Med Genet. 1978; 2: 81-98
- Etiologic factors in the amniotic band syndrome: a study of 24 patients.Birth Defects Orig Artic Ser. 1977; 13: 117-132
- Fetoscopic approach to amniotic band syndrome.J Pediatr Surg. 2014; 49: 359-362
- Fetoscopic release of umbilical cord amniotic band in a human fetus.Ultrasound Obstet Gynecol. 2009; 33: 232-234