Amniotic band syndrome associated with extremely severe atypical clefts of the orofacial region

Amniotic band syndrome (ABS) is not a commonly seen birth defect; however, it may have the potential to be severe and life-threatening requiring adequate attention. We present a severe case of amniotic band syndrome which encircled the head of the neonate tightly causing severe deformity. In this case report, the amniotic band encircled the head causing a severe bilateral Tessier 7 cleft. To our knowledge, this is the most severe type of ABS reported in the literature thus far.

Level of evidence: Level V, risk / therapeutic study.

Amniotic Band Syndrome: A Review of 2 Cases

Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero that presents with complex multisystem anomalies. The authors report 2 children with amniotic band syndrome who presented to the ophthalmic unit of the authors' pediatric hospital. One of them presented with telecanthus, syndactyly, amputated toes, and unilateral epiphora diagnosed as congenital nasolacrimal duct obstruction. She was managed conservatively with lacrimal sac massage and provided with refractive correction while she simultaneously underwent multiple surgeries for correction of clubfoot and craniosynostosis. The second patient presented with cleft lip, cleft palate, multiple constriction bands in upper limbs and fingers with unilateral microphthalmos, microcornea, typical iris coloboma, and retinochoroidal coloboma, very similar to a case reported in literature. These 2 cases provide an overview of the clinical spectrum of ophthalmic manifestations along with their staged optimum rehabilitation.

Extensive Nonunion of the Amnion: An Unusual Presentation of Amniotic Band Syndrome?

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.