1
|
Jahn AM, Wolf M, Herrmann J, Singer D, Jürgens J. [Transient Ischemia of One Leg in a Very Low Birthweight Infant]. Z Geburtshilfe Neonatol 2022; 226:278-281. [PMID: 35148543 DOI: 10.1055/a-1745-9258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ischemias in the extremities are rather rare in the neonatal period. Both intrauterine and postnatal factors can cause ischemias. We present the diagnostic procedure and the course in a female very low birthweight (VLBW) infant with transient ischemia in the lower extremity.
Collapse
Affiliation(s)
- Andreas Matthias Jahn
- Sektion Neonatologie und Pädiatrische Intensivmedizin, Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Wolf
- Sektion Neonatologie und Pädiatrische Intensivmedizin, Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Herrmann
- Abteilung für Kinderradiologie, Zentrum für Radiologie und Endoskopie, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Sektion Neonatologie und Pädiatrische Intensivmedizin, Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Jürgens
- Abteilung für Kinderradiologie, Zentrum für Radiologie und Endoskopie, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
2
|
Darakci SM, Ertuğrul S, Tanrıverdi Yılmaz S, Ünal E, Yolbaş İ, Değer İ. Infrequent association of two rare diseases: amniotic band syndrome and osteogenesis imperfecta. CASE REPORTS IN PERINATAL MEDICINE 2021. [DOI: 10.1515/crpm-2021-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Objectives
Amniotic band syndrome and osteogenesis imperfecta are two distinct diseases that develop due to structural defects of the collagen protein. In our paper, we report the concurrence of these two diseases rarely seen in the newborn period.
Case presentation
A female infant born at 33rd gestational week was found to have constrictive bands in her right lower extremity and flexion contractures in distal joints of lower and upper extremities due to amniotic bands in postnatal physical examination. While being treated for respiratory difficulty, she was diagnosed with osteogenesis imperfecta and treated with bisphosphonates upon being found to suffer bilateral humeral fractures on the sixth day of life. She received respiratory support with mechanical ventilation due to respiratory tract complications related to osteogenesis imperfecta and died on the 384th day of life.
Conclusions
One should bear in mind that other collagen tissue diseases may accompany the amniotic band syndrome; this possibility should be definitely pursued if clinical suspicion exists.
Collapse
Affiliation(s)
- Savaş Mert Darakci
- Pediatrics and Child Health, Diyarbakır Egil County State Hospital, Eğil , Diyarbakir , Turkey
| | - Sabahattin Ertuğrul
- Department of Neonatology , Dicle University School of Medicine , Diyarbakir , Turkey
| | | | - Edip Ünal
- Department of Pediatric Endocrinology , Dicle University School of Medicine , Diyarbakir , Turkey
| | - İlyas Yolbaş
- Department of Pediatrics and Child Health , Dicle University School of Medicine , Diyarbakir , Turkey
| | - İbrahim Değer
- Department of Neonatology , Dicle University School of Medicine , Diyarbakir , Turkey
| |
Collapse
|
3
|
Trout SM, Whitaker AT. Management issues of congenital talipes equinovarus in the neonatal intensive care unit: A systematic review. Foot Ankle Surg 2021; 27:480-485. [PMID: 32958391 DOI: 10.1016/j.fas.2020.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/17/2020] [Accepted: 07/10/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Ponseti method is the standard of care for managing idiopathic congenital talipes equinovarus (clubfoot) in the outpatient setting, but there are no clinical guidelines for inpatient treatment. Children in the neonatal intensive care unit (NICU) with clubfoot often delay treatment initiation due to medical reasons. METHODS We systematically reviewed literature related to the treatment of clubfoot in the NICU, non-idiopathic clubfoot, and older infants, as well as barriers to care. RESULTS In a mixed NICU population of syndromic and idiopathic clubfoot, the Ponseti method has good functional outcomes with minimal interference with medical management. The Ponseti method has good functional outcomes with reduced need for extensive surgical procedures in non-idiopathic clubfoot and idiopathic clubfoot with delayed presentation (under one year of age). CONCLUSIONS It is possible to begin Ponseti treatment in the NICU without compromising medical management. It is not clear if this confers an advantage over waiting for outpatient casting.
Collapse
Affiliation(s)
- Sally M Trout
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Amanda T Whitaker
- The Ohio State University College of Medicine, Columbus, OH, USA; Nationwide Children's Hospital, Orthopaedic Surgery, Columbus, OH, USA.
| |
Collapse
|
4
|
Chatterjee S, Rao KSM, Nadkarni A. Amniotic band syndrome associated with limited dorsal myeloschisis: a case report of an unusual case and review of the literature. Childs Nerv Syst 2021; 37:707-713. [PMID: 32519131 DOI: 10.1007/s00381-020-04713-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022]
Abstract
Amniotic band syndrome (ABS) has been known since ancient times. Descriptions in modern medicine have occurred since the mid-nineteenth century. The association of the amniotic band syndrome with tethered cord is rare. It was generally thought to be incompatible with life. Of late, with better imaging, there have been case reports of amniotic bands causing cord tethering in neurosurgical literature, but its association with limited dorsal myeloschisis has hitherto not been described. We report a case of amniotic band syndrome (ABS) associated with a cervical limited dorsal myeloschisis (LDM) in a child of 2 and a half years old. The management of LDM in ABS is essentially the same as in isolated cases.
Collapse
Affiliation(s)
- Sandip Chatterjee
- Department of Neurosurgery, Park Neurosciences, Park Clinic, 4 Gorky terrace, Kolkata, 700017, India.
| | | | | |
Collapse
|
5
|
da Silva AJF, Silva CSME, Mariano SCR. Amniotic band syndrome with double encephalocele: A case report. Surg Neurol Int 2020; 11:448. [PMID: 33408933 PMCID: PMC7771411 DOI: 10.25259/sni_454_2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/02/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Amniotic band syndrome (ABS) is a rare condition of controversial etiology that is associated with varying degrees of anomalies. This study reports a case of a newborn with ABS associated with double encephalocele in the frontal region. CASE DESCRIPTION A 29-year-old primiparous woman with no history of prenatal infection or consanguineous marriage had a cesarean section at gestational week 38, giving birth to a newborn who was well but had limb anomalies (constriction rings, amputations, and syndactyly) and craniofacial anomalies, mainly double frontal encephalocele. The patient underwent surgical repair and subsequent placement of a ventriculoperitoneal shunt. CONCLUSION Studies clarifying this uncommon association with double encephalocele are limited. ABS associated with double encephalocele is rare and even more complex when associated with other anomalies. Thus, the conditions in such children are severe and require multidisciplinary monitoring.
Collapse
Affiliation(s)
- Aldo Jose Ferreira da Silva
- Department of Pediatric Neurosurgery, Santa Monica Maternity School - Alagoas State University of Health Sciences, Maceio, Alagoas, Brazil
| | | | - Sonaly C. R. Mariano
- Department of Pediatrics, Neonatal Intensive Care Unit, Santa Monica Maternity School, Maceio, Alagoas, Brazil
| |
Collapse
|
6
|
Sharma D, Tsibizova VI. Current perspective and scope of fetal therapy: part 1. J Matern Fetal Neonatal Med 2020; 35:3783-3811. [PMID: 33135508 DOI: 10.1080/14767058.2020.1839880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Fetal therapy term has been described for any therapeutic intervention either invasive or noninvasive for the purpose of correcting or treating any fetal malformation or condition. Fetal therapy is a rapidly evolving specialty and has gained pace in last two decades and now fetal intervention is being tried in many malformations with rate of success varying with the type of different fetal conditions. The advances in imaging techniques have allowed fetal medicine persons to make earlier and accurate diagnosis of numerous fetal anomalies. Still many fetal anomalies are managed postnatally because the fetal outcomes have not changed significantly with the use of fetal therapy and this approach avoids unnecessary maternal risk secondary to inutero intervention. The short-term maternal risk associated with fetal surgery includes preterm labor, premature rupture of membranes, uterine wall bleeding, chorioamniotic separation, placental abruption, chorioamnionitis, and anesthesia risk. Whereas, maternal long-term complications include risk of infertility, uterine rupture, and need for cesarean section in future pregnancies. The decision for invasive fetal therapy should be taken after discussion with parents about the various aspects like postnatal fetal outcome without fetal intervention, possible outcome if the fetal intervention is done, available postnatal intervention for the fetal condition, and possible short-term and long-term maternal complications. The center where fetal intervention is done should have facility of multi-disciplinary team to manage both maternal and fetal complications. The major issues in the development of fetal surgery include selection of patient for intervention, crafting effective fetal surgical skills, requirement of regular fetal and uterine monitoring, effective tocolysis, and minimizing fetal and maternal fetal risks. This review will cover the surgical or invasive aspect of fetal therapy with available evidence and will highlight the progress made in the management of fetal malformations in last two decades.
Collapse
Affiliation(s)
- Deepak Sharma
- Department of Neonatology, National Institute of Medical Science, Jaipur, India
| | - Valentina I Tsibizova
- Almazov National Medical Research Centre, Health Ministry of Russian Federation, Saint Petersburg, Russia
| |
Collapse
|
7
|
Das N, Nagpal N, Bankura SS. A review on the advancements in the field of upper limb prosthesis. J Med Eng Technol 2019; 42:532-545. [PMID: 30875266 DOI: 10.1080/03091902.2019.1576793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Amputation is one of the serious issue across the globe which is mainly caused by trauma, medical illness or congenital condition. Because of steep increase in amputation incidences, the need for progress in technicality of prosthesis is becoming imperative. In this article, the journey of advancements in upper arm prosthesis has been discussed step by step. Moreover, it has also been enunciated that how from a simple replacement for an arm it now has reached the mark of giving a patient a fully functional limb with the help of sensors and myoelectric transducers that are able to translate the remaining muscle signals into full movement of the prosthesis. However, researches are still going on to make the design of the prosthetic more impressive having better range of movement, to establish its interface with brain more efficiently and to make the control of prosthetic more user friendly. In this review, a special emphasis has also been given to myoelectric prosthesis as this prosthetic system possesses a decisive influence on rehabilitation results. Moreover, this prosthetic system is extremely elegant and cutting-edge in both design and technology and offers a great wearer comfort.
Collapse
Affiliation(s)
- Nilanjan Das
- a Accendere, CL Educate Ltd. , New Delhi , India
| | - Nikita Nagpal
- b Department of Biotechnology , Manav Rachna International Institute of Research and Studies , Faridabad , India
| | - Shailee Singh Bankura
- b Department of Biotechnology , Manav Rachna International Institute of Research and Studies , Faridabad , India
| |
Collapse
|
8
|
Fan Z, Xue X, Perera R, Nasr Esfahani S, Exner AA, Fu J, Deng CX. Acoustic Actuation of Integrin-Bound Microbubbles for Mechanical Phenotyping during Differentiation and Morphogenesis of Human Embryonic Stem Cells. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2018; 14:e1803137. [PMID: 30427572 PMCID: PMC7228745 DOI: 10.1002/smll.201803137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/18/2018] [Indexed: 05/25/2023]
Abstract
Early human embryogenesis is a dynamic developmental process, involving continuous and concomitant changes in gene expression, structural reorganization, and cellular mechanics. However, the lack of investigation methods has limited the understanding of how cellular mechanical properties change during early human embryogenesis. In this study, ultrasound actuation of functionalized microbubbles targeted to integrin (acoustic tweezing cytometry, ATC) is employed for in situ measurement of cell stiffness during human embryonic stem cell (hESC) differentiation and morphogenesis. Cell stiffness, which is regulated by cytoskeleton structure, remains unchanged in undifferentiated hESCs, but significantly increases during neural differentiation. Further, using the recently established in vitro 3D embryogenesis models, ATC measurements reveal that cells continue to stiffen while maintaining pluripotency during epiblast cyst formation. In contrast, during amniotic cyst formation, cells first become stiffer during luminal cavity formation, but softens significantly when cells differentiate to form amniotic cysts. These results suggest that cell stiffness changes not only due to 3D spatial organization, but also with cell fate change. ATC therefore provides a versatile platform for in situ measurement of cellular mechanical property, and cell stiffness may be used as a mechanical biomarker for cell lineage diversification and cell fate specification during embryogenesis.
Collapse
Affiliation(s)
- Zhenzhen Fan
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Xufeng Xue
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Reshani Perera
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Sajedeh Nasr Esfahani
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Agata A Exner
- Department of Radiology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Jianping Fu
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Cheri X Deng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| |
Collapse
|
9
|
Gosavi M, Srevatsa K, Ranjit PK, Joshi K. Amniotic band syndrome: A case report and review of literature. JOURNAL OF THE SCIENTIFIC SOCIETY 2018. [DOI: 10.4103/jss.jss_22_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
10
|
Bray JJH, Crosswell S, Brown R. Congenital talipes equinovarus and congenital vertical talus secondary to sacral agenesis. BMJ Case Rep 2017; 2017:bcr-2017-219786. [PMID: 28476907 DOI: 10.1136/bcr-2017-219786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sacral agenesis is a rare congenital defect which is associated with foot deformities such as congenital talipes equinovarus (CTEV) and less commonly congenital vertical talus (CVT). We report a 3-year-old Caucasian girl who was born with right CTEV and left CVT secondary to sacral agenesis. Her right foot was managed with a Ponseti casting method at 2 weeks, followed by an Achilles tenotomy at 4 months. The left foot was initially managed with a nocturnal dorsi-flexion splint. Both feet remained resistant and received open foot surgery at 10 months producing plantigrade feet with neutral hindfeet. At 19 months, she failed to achieve developmental milestones and examinations revealed abnormal lower limb reflexes. A full body MRI was performed which identified the sacral agenesis. We advocate early MRI of the spine to screen for spinal defects when presented with resistant foot deformities, especially when bilateral.
Collapse
Affiliation(s)
- Jonathan James Hyett Bray
- Trauma and Orthopaedic Department, Cheltenham General Hospital, Cheltenham, UK.,Bristol Royal Infirmary, University of Bristol Academy, Bristol, UK
| | - Sebastien Crosswell
- Department of General Surgery, The Royal Shrewsbury Hospital, Shrewsbury, UK
| | - Rick Brown
- Trauma and Orthopaedic Department, Cheltenham General Hospital, Cheltenham, UK
| |
Collapse
|
11
|
A Rare Case of Unilateral Isolated Naso-Ocular Cleft Treated by a Rotation-Advancement Technique. J Craniofac Surg 2017; 27:1782-1784. [PMID: 27483102 DOI: 10.1097/scs.0000000000002946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The isolated naso-ocular cleft is rare. In this article, the authors report an extremely rare case of unilateral isolated naso-ocular cleft. And a new rotation-advancement technique was used in repair. Result was satisfied, especially the esthetical scar location. But if an upper lid flap was performed simultaneously, the result should be better.
Collapse
|
12
|
The Anaesthesiologist and Palliative Care in a Newborn with the Adam "Sequence". Case Rep Anesthesiol 2017; 2017:6230923. [PMID: 28326200 PMCID: PMC5343242 DOI: 10.1155/2017/6230923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/17/2017] [Accepted: 02/07/2017] [Indexed: 11/18/2022] Open
Abstract
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM “sequence,” in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation. Urgent surgery was performed, after which the newborn was transported to the ICU and intubated under controlled mechanical ventilation. The patient died a week later. The principles of beneficence, nonmaleficence, justice, and respect for autonomy are simultaneously an inspiratory and regulatory framework for clinical practice. Although only necessary procedures are defended, which suggests a position contrary to invasive interventions at the end of life, sometimes they are the best palliative measures that can be taken in cases like the one described here.
Collapse
|
13
|
Amniotic Band Syndrome, Perinatal Hospice, and Palliative Care versus Active Management. Case Rep Obstet Gynecol 2016; 2016:9756987. [PMID: 28025631 PMCID: PMC5153497 DOI: 10.1155/2016/9756987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/14/2016] [Accepted: 09/04/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence. The pregnancy was subsequently complicated by preterm premature rupture of membranes with oligohydramnios, resulting in a surviving neonate scheduled for rehabilitative treatment. Conclusion. Amniotic band syndrome is an uncommon congenital anomaly resulting in multiple disfiguring and disabling manifestations. Several theories are proposed with most involving early rupture of the amnion and entanglement of fetal parts by amniotic bands. This syndrome can be manifested by development of multiple malformations, with the majority of the defects being limb abnormalities of a disorganized nature, as in the case we present. In the absence of a clear etiology of consequential congenital abnormalities, obstetric management guidelines should use shared decision models to focus on the quality of life for the offspring.
Collapse
|
14
|
Carpiaux AM, Hosseinzadeh P, Muchow RD, Iwinski HJ, Walker JL, Milbrandt TA. The Effectiveness of the Ponseti Method for Treating Clubfoot Associated With Amniotic Band Syndrome. J Pediatr Orthop 2016; 36:284-8. [PMID: 25985370 DOI: 10.1097/bpo.0000000000000444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Amniotic band syndrome (ABS) is a congenital disorder with an associated incidence of clubfoot deformity in over 50% of patients. Although early reports in the literature demonstrated a poor response to casting treatments, recent application of the Ponseti technique in ABS patients have been more promising. METHODS A retrospective review of all patients with clubfoot and a concurrent diagnosis of ABS were reviewed at a single institution. Patients not managed initially with the Ponseti method were excluded. Data collected included patient age at presentation, sex, unilateral or bilateral, amniotic band location and associated findings, and response to treatment-number of casts and requirement of Achilles tenotomy, tibialis anterior tendon transfer, or other surgical procedures. Duration of treatment at latest follow-up visit was noted and outcome was based on clinical foot appearance and plan for any further procedures. RESULTS Twelve patients (7 female and 5 male) with a total of 21 feet (9 bilateral and 3 unilateral) were identified. The average age at presentation was 3 weeks (range, 1 to 9 wk). The average number of casts was 6 (range, 3 to 11). Seventeen of 21 feet (81.0%) underwent percutaneous Achilles tenotomy. The initial correction rate for all patients with the Ponseti technique was 20/21 feet (95.2%) and recurrence was noted in 7/21 feet (33.3%). One patient underwent primary posteromedial release and 2 patients had associated neurological deficits. The average follow-up was 3.9 years (range, 9 mo to 10 y) and all but one patient had supple, plantigrade feet. CONCLUSION The Ponseti technique is an effective first-line treatment in patients who have clubfeet associated with ABS, including those with a neurological deficit. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Aaron M Carpiaux
- *Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky ‡Shriners Hospital for Children, Lexington, KY †Baptist Pediatric Orthopaedics Center, Miami, FL
| | | | | | | | | | | |
Collapse
|
15
|
Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects. Am J Obstet Gynecol 2016; 215:613.e1-613.e11. [PMID: 27443814 DOI: 10.1016/j.ajog.2016.07.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/01/2016] [Accepted: 07/07/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND While associations between secondhand smoke and a few birth defects (namely, oral clefts and neural tube defects) have been noted in the scientific literature, to our knowledge, there is no single or comprehensive source of population-based information on its associations with a range of birth defects among nonsmoking mothers. OBJECTIVE We utilized data from the National Birth Defects Prevention Study, a large population-based multisite case-control study, to examine associations between maternal reports of periconceptional exposure to secondhand smoke in the household or workplace/school and major birth defects. STUDY DESIGN The multisite National Birth Defects Prevention Study is the largest case-control study of birth defects to date in the United States. We selected cases from birth defect groups having >100 total cases, as well as all nonmalformed controls (10,200), from delivery years 1997 through 2009; 44 birth defects were examined. After excluding cases and controls from multiple births and whose mothers reported active smoking or pregestational diabetes, we analyzed data on periconceptional secondhand smoke exposure-encompassing the period 1 month prior to conception through the first trimester. For the birth defect craniosynostosis, we additionally examined the effect of exposure in the second and third trimesters as well due to the potential sensitivity to teratogens for this defect throughout pregnancy. Covariates included in all final models of birth defects with ≥5 exposed mothers were study site, previous live births, time between estimated date of delivery and interview date, maternal age at estimated date of delivery, race/ethnicity, education, body mass index, nativity, household income divided by number of people supported by this income, periconceptional alcohol consumption, and folic acid supplementation. For each birth defect examined, we used logistic regression analyses to estimate both crude and adjusted odds ratios and 95% confidence intervals for both isolated and total case groups for various sources of exposure (household only; workplace/school only; household and workplace/school; household or workplace/school). RESULTS The prevalence of secondhand smoke exposure only across all sources ranged from 12.9-27.8% for cases and 14.5-15.8% for controls. The adjusted odds ratios for any vs no secondhand smoke exposure in the household or workplace/school and isolated birth defects were significantly elevated for neural tube defects (anencephaly: adjusted odds ratio, 1.66; 95% confidence interval, 1.22-2.25; and spina bifida: adjusted odds ratio, 1.49; 95% confidence interval, 1.20-1.86); orofacial clefts (cleft lip without cleft palate: adjusted odds ratio, 1.41; 95% confidence interval, 1.10-1.81; cleft lip with or without cleft palate: adjusted odds ratio, 1.24; 95% confidence interval, 1.05-1.46; cleft palate alone: adjusted odds ratio, 1.31; 95% confidence interval, 1.06-1.63); bilateral renal agenesis (adjusted odds ratio, 1.99; 95% confidence interval, 1.05-3.75); amniotic band syndrome-limb body wall complex (adjusted odds ratio, 1.66; 95% confidence interval, 1.10-2.51); and atrial septal defects, secundum (adjusted odds ratio, 1.37; 95% confidence interval, 1.09-1.72). There were no significant inverse associations observed. CONCLUSION Additional studies replicating the findings are needed to better understand the moderate positive associations observed between periconceptional secondhand smoke and several birth defects in this analysis. Increased odds ratios resulting from chance (eg, multiple comparisons) or recall bias cannot be ruled out.
Collapse
|
16
|
Shay S, West AN. Ankyloglossia superior syndrome: Case report and updated literature review. Int J Pediatr Otorhinolaryngol 2016; 86:1-3. [PMID: 27260569 DOI: 10.1016/j.ijporl.2016.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 10/22/2022]
Abstract
Ankyloglossia superior (palatoglossal adhesion) is an extremely rare congenital condition with only 14 previously reported cases. When found in conjunction with other congenital abnormalities, such as cleft palate, gastrointestinal malformations, and limb malformations, this anomaly is considered part of ankyloglossia superior syndrome. We present a case of a newborn female found to have ankyloglossia superior syndrome. Surgical repair is also described. We review the available literature and discuss theories regarding the etiology of ankyloglossia superior syndrome. Clinicians should have a high degree of suspicion for other congenital anomalies when a neonate is found to have ankyloglossia superior.
Collapse
Affiliation(s)
- Sophie Shay
- Department of Head and Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, 10833 Le Conte Ave, CHS 62-237, Los Angeles, CA 90095, USA.
| | - Alisha N West
- Department of Head and Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, 200 Medical Plaza, Suite 550, Los Angeles, CA 90095, USA
| |
Collapse
|
17
|
Xu Y, Mu Y, Chen R, Zheng Z, Zhang W. Two rare cases of simultaneous Tessier number 3 cleft, contralateral cleft lip, and signs of amniotic band syndrome. J Craniomaxillofac Surg 2016; 44:672-5. [PMID: 27052637 DOI: 10.1016/j.jcms.2015.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 10/10/2015] [Accepted: 11/17/2015] [Indexed: 11/29/2022] Open
Abstract
The Tessier number 3 cleft is rare. In this paper, we report two extremely rare cases of simultaneous Tessier number 3 cleft, contralateral cleft lip, and signs of amniotic band syndrome. In the two cases, we confirmed that amniotic bands were the probable cause of the Tessier number 3 cleft, where swallowed fibrous strands of amniotic bands entangle a typical cleft lip and cause the more severe Tessier number 3 cleft. In this study, Z-plasty was performed for one case, and a straight-line method was used for the other. Postoperatively, the appearance of both patients was satisfactory, as expected. Consequently, treatment for the Tessier number 3 cleft should be designed individually based on the severity of deformity.
Collapse
Affiliation(s)
- Yi Xu
- Department of Plastic and Traumatic Surgery, School of Stomatology, Capital Medical University, No.4, Tiantan West, East District, Beijing, 100050, China
| | - Yue Mu
- Department of Plastic and Traumatic Surgery, School of Stomatology, Capital Medical University, No.4, Tiantan West, East District, Beijing, 100050, China
| | - Renji Chen
- Department of Plastic and Traumatic Surgery, School of Stomatology, Capital Medical University, No.4, Tiantan West, East District, Beijing, 100050, China.
| | - Zongmei Zheng
- Department of Plastic and Traumatic Surgery, School of Stomatology, Capital Medical University, No.4, Tiantan West, East District, Beijing, 100050, China
| | - Wenjing Zhang
- Department of Plastic and Traumatic Surgery, School of Stomatology, Capital Medical University, No.4, Tiantan West, East District, Beijing, 100050, China
| |
Collapse
|
18
|
Öztürk F, Hatunoğlu E, Altun O. Nasoalveolar Molding Treatment for a Patient With Amniotic Band Syndrome: A Case Report. Turk J Orthod 2014. [DOI: 10.13076/tjo-d-14-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Abstract
BACKGROUND A clubfoot deformity may be associated with congenital annular band syndrome (CABS), and has, until recently, been thought to be resistant to nonoperative management. The purpose of this report was to describe the use of the Ponseti method in the treatment of 5 patients whose clubfeet were associated with this syndrome. METHODS All patients with a diagnosis of clubfoot, who were treated at the Orthopaedic Hospital Clubfoot Clinic, over a period of 4 years, were reviewed. During that period, a total of 131 infants with 194 clubfeet were treated. We identified 5 infants (3.8%) with 6 clubfeet associated with CABS. The patients were managed using the Ponseti method. One of the patients, with a contralateral amputation of the limb opposite to the side with a clubfoot, required the use of a unilateral foot abduction orthosis rather than a conventional foot abduction orthosis. The outcomes evaluated included: the number of casts needed to obtain correction, the percentage of patients requiring a tendo-Achilles tenotomy, the number of relapses, and the need for additional secondary procedures. RESULTS The mean age at presentation for the 5 patients was 6.2 weeks. Four of the clubfeet had an ipsilateral band and 2 did not. None of the patients had a neurological deficit distal to a band. The mean number of casts used to correct the deformity was 6, and a percutaneous tendo-Achilles tenotomy was done in all cases. All of the feet achieved initial correction. Four patients (5 feet) experienced a relapse attributed to failure to use the postcorrective brace as prescribed. Correction of the foot in 3 of these patients was regained and maintained by another series of manipulation and cast application followed by resumption of bracing. One patient underwent an anterior tibial tendon transfer. The patients were followed for an average of 32.6 months (21 to 49 mo). All feet were supple and plantigrade at latest follow-up evaluation. CONCLUSIONS The Ponseti method may be successfully applied to clubfeet associated with CABS. LEVEL OF EVIDENCE Level IV.
Collapse
|
20
|
Derderian SC, Iqbal CW, Goldstein R, Lee H, Hirose S. Fetoscopic approach to amniotic band syndrome. J Pediatr Surg 2014; 49:359-62. [PMID: 24528986 DOI: 10.1016/j.jpedsurg.2013.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Amniotic band syndrome (ABS) is an uncommon complication of pregnancy that can result in fetal demise. METHODS We present our experience with fetoscopic amniotic band release. RESULTS Five patients underwent fetoscopic amniotic band release for preoperatively diagnosed ABS involving at least one extremity. Four of five patients were found to have involvement of the umbilical cord at the time of fetoscopy. One of these four did not have the band released and underwent fetal demise at 24 weeks. All four survivors had good functional outcomes of affected limbs. Two patients developed membrane separation and had preterm deliveries at 32 weeks gestation whereas the other two carried to term. No maternal complications were noted. CONCLUSIONS Fetoscopic amniotic band release is safe. Umbilical cord involvement is difficult to assess preoperatively, but when it is present should be treated to reduce the risk of fetal demise.
Collapse
Affiliation(s)
- S Christopher Derderian
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Corey W Iqbal
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Ruth Goldstein
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Radiology, the University of California, San Francisco, CA 94143-0570, USA
| | - Hanmin Lee
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Shinjiro Hirose
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA.
| |
Collapse
|
21
|
Shetty P, Menezes LT, Tauro LF, Diddigi KA. Amniotic band syndrome. Indian J Surg 2014; 75:401-2. [PMID: 24426485 DOI: 10.1007/s12262-012-0468-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 03/06/2012] [Indexed: 11/28/2022] Open
Abstract
Amniotic band syndrome is an uncommon congenital disorder without any genetic or hereditary disposition. It involves fetal entrapment in strands of amniotic tissue and causes an array of deletions and deformations. Primary treatment is plastic and reconstructive surgery after birth with in utero fetal surgery also coming in vogue.
Collapse
Affiliation(s)
- Prathvi Shetty
- Department of Surgery, Father Muller Medical College and Hospital, Kankanady, Mangalore, 575002 Karnataka India
| | - Leo Theobald Menezes
- Department of Plastic Surgery, Father Muller Medical College and Hospital, Kankanady, Mangalore, 575002 Karnataka India
| | - Leo Francis Tauro
- Department of Surgery, Father Muller Medical College and Hospital, Kankanady, Mangalore, 575002 Karnataka India
| | - Kumar Arun Diddigi
- Department of Surgery, Father Muller Medical College and Hospital, Kankanady, Mangalore, 575002 Karnataka India
| |
Collapse
|
22
|
Amniotic band syndrome with tethering of the spinal cord: a case-based update. Childs Nerv Syst 2011; 27:211-4. [PMID: 21080173 DOI: 10.1007/s00381-010-1333-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 11/02/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Amniotic band syndrome consists of a wide spectrum of clinical manifestations attributed to entanglement and disruption of different developing parts of the embryo. Multiple asymmetric encephalocele and anencephaly have previously been reported with amniotic band syndrome. Tethering of the spinal cord secondary to amniotic band constriction is exceedingly rare, and this is the second reported case in the literature. CASE REPORT We present a case of amniotic band resulting in tethering of spinal cord. It is a rare entity, and it is the second reported case of amniotic band causing tethering of the spinal cord. Standard operative approach was used to untether the cord. The child made good post-op recovery without any neurological deterioration. A review of the literature and causative theories is discussed. CONCLUSIONS Neural tube defects involving head and spine are thought to result from adhesions between craniofacial structures and chorionic wall or compression forces by amniotic bands. Tethering of the thoracic spinal cord with amniotic band is an exceedingly rare occurrence. It is a rare entity, but it can be treated with a conventional approach with a favourable outcome.
Collapse
|
23
|
An unusual amniotic rupture sequence with thoracoabdominal restricting band, low-set posterior hairline, and trapezius contracture. J Craniofac Surg 2010; 21:1400-3. [PMID: 20818258 DOI: 10.1097/scs.0b013e3181ebcd6b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Amniotic rupture sequence is associated with defects of variable severity and at different sites. Analysis of the literature reveals difficulties in the classification, which, in addition to uncertainties surrounding its causes, make diagnosis of unusual presentations rather difficult. We present an unusual case of a thoracoabdominal restrictive band from the umbilicus to a low-set posterior hairline with severe trapezius contracture, sternoclavicular dislocation, and no associated craniofacial or limb abnormalities. Amnion rupture sequence with adhesion band seems to be the most probable cause of this rare combination of anomalies.
Collapse
|
24
|
Hill DS. Extensive Nonunion of the Amnion: An Unusual Presentation of Amniotic Band Syndrome? JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2010. [DOI: 10.1177/8756479310378891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Amniotic band syndrome is a relatively rare condition affecting approximately 1 in 1200 live births, where the amniotic membrane ruptures from the chorion, leaving the fetus exposed to injury due to entrapment of body parts within the membranous strands. This case demonstrates what appears to be virtually complete nonunion, or complete rupture of the amnion from the chorion with deformity and amputation of a fetal foot and toes revealed at birth.
Collapse
|
25
|
Sinha R, Singh B, Kiran YK, Singh D, Raman TSR. Amniotic Band Disruption Sequence. Med J Armed Forces India 2009; 65:274-5. [DOI: 10.1016/s0377-1237(09)80025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 03/30/2009] [Indexed: 10/18/2022] Open
|
26
|
Hüsler MR, Wilson RD, Horii SC, Bebbington MW, Adzick NS, Johnson MP. When is fetoscopic release of amniotic bands indicated? Review of outcome of cases treatedin uteroand selection criteria for fetal surgery. Prenat Diagn 2009; 29:457-63. [DOI: 10.1002/pd.2222] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
27
|
Abstract
Constriction band syndrome is an uncommon congenital abnormality with multiple disfiguring and disabling manifestations. Early amnion rupture with subsequent entanglement of fetal parts by amniotic strands is currently the primary theory for the development of this syndrome. Management of constriction band syndrome is focused on improving function and development while providing a more acceptable esthetic appearance. The treatment should be tailored to the individual. Timing of repair and surgical planning are important to provide the best functional results for affected hands.
Collapse
Affiliation(s)
- Kenji Kawamura
- Department of Orthopaedic Surgery, Nara Medical University, Shijyo-cho, Kashihara, Japan
| | | |
Collapse
|
28
|
O'Shea MK, Pillman SH, O'Shea R. Congenital third foot deformity: a case report. J Foot Ankle Surg 2008; 47:583-8. [PMID: 19239872 DOI: 10.1053/j.jfas.2008.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Indexed: 02/03/2023]
Abstract
A congenital accessory limb is a rare condition that may be associated with predisposing factors such as drug or alcohol or toxin exposure, trauma, and deformities such as spina bifida. This article describes a case involving an accessory foot in an otherwise healthy 33-year-old male. It is likely that the etiology of this case was an early embryologic exposure to amniotic constriction bands that affected the development of the distal limb.
Collapse
|
29
|
Narang M, Khalil S, Faridi MMA. Amniotic band syndrome. Indian J Pediatr 2008; 75:754. [PMID: 18716750 DOI: 10.1007/s12098-008-0144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 01/04/2008] [Indexed: 02/05/2023]
Affiliation(s)
- Manish Narang
- Department of Paediatrics, University College of Medical Sciences and GTB Hospital, Delhi, India.
| | | | | |
Collapse
|
30
|
Abstract
Adactyly (terminal transverse hemimelia) is a rare condition in the cat. The clinical and radiographic findings in a one-year-old cat with bilateral hindlimb adactyly are described. The cat was treated conservatively and appeared to cope well with its deformity.
Collapse
Affiliation(s)
- K R Barrand
- Fenwold Veterinary Practice Ltd, Heath Road, Skegness, Lincs PE25 3ST
| | | |
Collapse
|
31
|
Cham PMH, Drolet BA, Segura AD, Esterly NB. Congenital Volkmann ischaemic contracture: a case report and review. Br J Dermatol 2004; 150:357-63. [PMID: 14996111 DOI: 10.1111/j.1365-2133.2004.05817.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Congenital Volkmann ischaemic contracture or neonatal compartment syndrome has rarely been discussed in the literature of dermatology. The condition often involves the upper extremity with cutaneous lesions, contractures and neuropathy. Because the lesions can be mistaken for other entities including necrotizing fasciitis, neonatal gangrene, congenital varicella, aplasia cutis congenita, amniotic band syndrome, subcutaneous fat necrosis and epidermolysis bullosa, dermatologists play a significant role in the diagnosis and, consequently, the treatment of the patient. We describe a premature newborn who had a unilateral, well-demarcated necrotic plaque with a central pallor at birth. The plaque extended circumferentially over the left forearm from the wrist to the elbow. Left wrist oedema, bullae over the fingers and flaccid paralysis at the wrist were also noted.
Collapse
Affiliation(s)
- P M H Cham
- Department of Dermatology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
| | | | | | | |
Collapse
|
32
|
Abstract
Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies. Isolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encountered 50 cases involving focal musculoskeletal anomalies, including focal limb dysplasia [radial ray abnormality (n=3), mesomelic dysplasia (n=1)]; anomalies of the hand [polydactyly (n=8), syndactyly (n=3), ectrodactyly (n=1), clinodactyly (n=6), clenched hand (n=5)]; anomalies of the foot [clubfoot (n=10), rockerbottom foot (n=5), sandal gap deformity (n=1), curly toe (n=2)]; amniotic band syndrome (n=3); and anomalies of the focal spine [block vertebra (n=1), hemivertebra (n=1)]. Among these 50 cases, five [polydactyly (n=1), syndactyly (n=2) and curly toe (n=2)] were confirmed by postnatal physical evaluation, two (focal spine anomalies) were diagnosed after postnatal radiologic examination, and the remaining 43 were proven at autopsy. For each condition, we describe the prenatal sonographic findings, and include a brief review.
Collapse
Affiliation(s)
- Jung Kyu Ryu
- Department of Diagnostic Radiology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | | | | |
Collapse
|
33
|
Pardini Jr. AG, Santos MAD, Freitas AD. Bandas de constrição congênitas. ACTA ORTOPEDICA BRASILEIRA 2001. [DOI: 10.1590/s1413-78522001000200001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A síndrome da banda de constrição congênita é uma patologia rara, de ocorrência ocasional na natureza e não existe predisposição genética. É freqüentemente associada a amputações de dedos ou membros, sindactilia, acrossindactilia (sindactilia fenestrada), mal formações em face, tórax e/ou abdômen. O presente trabalho representa nossa experiência na abordagem e tratamento da Síndrome da Banda de Constrição Congênita. Foram tratados 10 pacientes atendidos em nosso serviço em um período de 20 anos.
Collapse
|
34
|
Stanek J, de Courten-Myers G, Spaulding AG, Strub W, Hopkin RJ. Case of complex craniofacial anomalies, bilateral nasal proboscides, palatal pituitary, upper limbs reduction, and amnion rupture sequence: disorganization phenotype? Pediatr Dev Pathol 2001; 4:192-202. [PMID: 11178637 DOI: 10.1007/s100240010131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a case of a dizygotic twin with complex abnormalities of head, body, and limbs. The anomalies include the following: lateral and midline cleft upper lip, ectopic palatal pituitary, natal teeth, bilateral nasal proboscides with an absent nose, left microphthalmia with conjunctival-lined cyst, right ocular dysgenesis, bilateral retinal dysplasia, platybasia with skull asymmetry, hydrocephalus secondary to aqueductal atresia, brain hemispheric asymmetry with a parietal-occipital cortical flap, agenesis of posterior corpus callosum, absence of the olfactory nerves and left anterior cerebral artery, leptomeningeal and intraventricular heterotopias, right radial longitudinal terminal meromelia with constriction rings of fingers, partial syndactyly of the third and fourth left fingers, dorsiflexed great toes and pes equinovarus bilaterally, and multiple skin tags with a sacral appendage. Additionally, this twin's placental disc and extraplacental membranes were devoid of amnion. We regard these anomalies as a possible expression of the human homologue of the disorganization phenotype or another gene mutation. Nevertheless, an abnormality of blastogenesis with early damage to organizing tissues of the frontonasal region and limbs, or a vascular disruption, cannot be excluded. Early amnion rupture sequence (possible extraamniotic pregnancy with amniotic bands, limb reduction defects with Streeter bands, and multiple skin tags tapering into amniotic bands) was also present in this case, and may have acted as a contributing factor.
Collapse
Affiliation(s)
- J Stanek
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, OH 45267-0529, USA
| | | | | | | | | |
Collapse
|