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During pregnancy it is very important that the woman carry out all the medical checks to prevent possible malformations of the baby, just as it is vital that she takes care of her diet and is very aware of the rhythm of life she leads (it must be slow and without stress). In this way it is possible, perhaps (just perhaps), to prevent the fetus from suffering the amniotic band syndrome, Although this disease, according to experts, it cannot be determined that it occurs due to something in particular but it is random and not hereditary.
The commonly called 'bag of waters' or amniotic bag is formed around the eighth day of gestation. It is a layer that surrounds the fetus surrounded by amniotic fluid, which serves as protection and provides it with a suitable environment to develop. It is made up of two thin membranes called the chorion and amnion. The amnion is the inner layer that directly contains the fetus and the amniotic fluid, while the chorion is the outer or placental part.
Heamniotic band syndrome is a group of birth defects that occurs when any part of the fetus is 'cut' or 'strangled' by a fibrous-like amniotic band inside the uterus, which restricts blood flow, affecting the development of the baby. This produces abnormalities in the baby.
It can cause different defects depending on the fetal parts that are affected. If these fibers or bands get 'tangled' around a limb (arm or leg) it may be amputated, and it will depend on in which area it happens, which portion of the limb is lost.
It can happen that the damage is slight, manifested by the appearance of simple folds that do not impede the functioning of any organ. Deep furrows, further development of one of the limbs, nail dystrophy, encephalocele, etc.
If the bands are placed on the face, they can cause a cleft lip and palate. It can be lethal when the band is placed around the umbilical cord and prevents the placental blood supply from reaching the baby, thereby causing an abortion.
This disease is not genetic, nor is it caused by any controllable factor, it occurs randomly and is very rare for it to recur in a subsequent pregnancy. For all this, we can say that it is a rare disease, not hereditary, with multiple manifestations and that it can cause disabilities in the fetus. Its incidence is between 1 affected baby in 1,200 alive to 1 affected baby in 15,000 live births. (varies by geography).
The most accepted etiology to explain this syndrome is that at the beginning of pregnancy the inner membrane of the bag, the amnion that we mentioned at the beginning, breaks without damaging the other membrane and therefore the bag remains 'intact'. The layer that breaks off forms strips of stringy, sticky tissue that float in the amniotic fluid and can 'tangle' with the fetus.
Some authors point out how possible cause, trauma from amniocentesis, a severe blow or fall, ionizing radiation, infections, or very great maternal efforts.
It is believed to happen between 28 days post conception and the first 18 weeks of pregnancy. The sooner it occurs, the worse the associated prognosis, since the defects are more severe. If it occurs after the first 45 days, the defects are likely to be more limited and therefore less serious.
It is very difficult to make a prenatal diagnosis, sometimes the flanges or bands are seen in the ultrasound, but they are very thin 'cords' and it is very difficult to distinguish them with the ultrasound of the ultrasound. When it is diagnosed using this method, it is usually because the injury is seen and not its cause. On some occasions, bands of constriction are seen on ultrasound suggesting amniotic bands.
In case of suspicion, an MRI can be requested to confirm the diagnosis and damage. In general, the diagnosis is therefore made after birth by visualizing the damage.
Regarding treatment, it will vary depending on the magnitude and presence of abnormalities in the fetus / newborn. When intrauterine diagnosis is made, intrauterine fetal treatment with release of the constriction child can sometimes be considered in cases of risk of irreversible damage. It is a minimally invasive treatment for the mother, which is normally performed under local anesthesia with a small incision in the abdomen.
In most cases, the treatment will be carried out post-birth and is generally symptomatic and individualized to each baby, since it will depend on the degree of affectation. Sometimes it is necessary to perform surgery immediately after birth when it is life-threatening; if the treatment is aesthetic, it will be done later.
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