Amniotic band syndrome is still incompletely understood abnormality in which the fibrous bands entrap various parts of the fetal body, including the limbs, the trunk, the abdomen, as well as the cranium. The severity of injuries ranges from mild constrictive changes on the skin to mutilations and complete amputations. As the condition may be life-threatening, prenatal imaging studies (mainly ultrasonography) are necessary for making an early diagnosis.
The clinical presentation of amniotic band syndrome stems from the interaction of the fetus with the abnormal fibrous tissue within amniotic cavity . Virtually all cases display a unique collection of manifestations, ranging from only mild cutaneous signs to severe and life-threatening injuries  . Almost any anatomical region in the body can be entrapped by amniotic bands, as studies have reported the head, the trunk, and both proximal and distal extremities as potential sites where defects have occurred    . Limb abnormalities, however, seem to be the most common - focal constriction, brachydactyly, and peripheral nerve damage are typical cases, whereas injuries resulting in mutilations and total amputations are also possible     . In more recent studies, approximately 50% of patients showed isolated mutilation and/or constriction of distal parts of fingers and toes, without the presence of any additional abnormalities . Typical defects of the trunk are related to the abdominal organs, where gastroschisis and gastropleuroschisis may be encountered, while spinal deformities, such as kyphosis, lordosis, and scoliosis are also frequently discovered in amniotic band syndrome . In fact, the concomitant presence of spinal pathologies and defects of the abdominal wall are considered to be highly specific for amniotic band syndrome . Newborns are could have different injuries of the cranium and face - acalvaria, acrania, encephalocele, microphthalmia, facial clefts, and nasal deformities   .
Illustrated is the difficulty in making the prenatal diagnosis of cystic hydroma and its confusion with amniotic band syndrome. [ncbi.nlm.nih.gov]
Amniotic Band Syndrome – Alternative Names Some of these are different names for ABS and some are other syndromes that are often confused with ABS. Misdiagnosis is apparently common. [amnioticbandsyndrome.com]
The overabundance of synonyms/acronyms used to describe the congenital malformations in ABS attest partly to the confusion surrounding its etiology. [podiatrynetwork.com]
His postoperative course was complicated by meningitis with subsequent hydrocephalus necessitating ventriculoperitoneal shunt placement. [ncbi.nlm.nih.gov]
Recently, he developed foot-drop due to pressure on the right common peroneal nerve by the constriction ring of the leg. [ncbi.nlm.nih.gov]
Since it is necessary to evaluate the extent of limb and organ damage as soon as possible for the purposes of planning the optimal treatment, the diagnosis of amniotic band syndrome should be made prenatally. Fetal ultrasonography is regarded as the cornerstone for detecting edema of the limbs or fingers distally from where the amniotic band is located . A prenatal diagnosis may be difficult, however, particularly in the earlier stages. More advanced imaging studies, including 4D ultrasonography and magnetic resonance imaging (MRI), have been also described as potentially useful methods  .
To raise a clinical suspicion, several risk factors have been proposed. Although no hereditary components of the disease are described, amniotic band syndrome is much more likely to develop in the setting of a positive family history . As mentioned previously, several congenital abnormalities are associated with this condition such as cleft lip, cleft palate, and micrognathia, but also specific genetic syndromes such as Patau syndrome . Interestingly, women living in high altitudes were shown to be at a much higher risk for carrying fetuses who develop this syndrome, whereas a history of febrile illnesses, use of pharmacological agents, and vaginal bleeding in the first trimester were observed as significant maternal factors  .
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