Syndrome amniotic bands (Streeter dysplasia) - Diagnosis and treatment

DiagnosisBecause amniotic band syndrome is an extrinsic phenomenon spontaneously, there is no laboratory test to confirm its presence. Alpha-fetoprotein level is elevated in normal acetylcholinesterase activity but this increase may be due to fetal death or anencephaly.
Imaging Studies:Serial echography may demonstrate lack of development, such as an intrauterine anencefalus or amputation, but are nonspecific and disappointing. Prenatal diagnosis of a facial cleft should alert the physician to the possibility of amniotic band syndrome and other abnormalities. This counseling helping parents. MRI may be indicated to memrele strip preoperativ deep to assess neurovascular status. Magnetic resonance angiography may show deficits of the affected limb vascular anatomy and surgical variable that may affect prognosis.Amniocentesis was associated with risk of fetal membranes rupture and is not recommended.
Treatment
Because the syndrome is a phenomenon caused intrauterine rupture of amniotic membranes and probably tissue constriction which develops, there is no medical treatment. It is advisable to avoid certain drugs that lead to spontaneous rupture of membranes such as cocaine and mifepristone to reduce risk.
Surgical therapy:The tight bands around the limbs and fingers needed urgent surgical treatment for patients with vascular compromise. Surgery is indicated for patients with or acrosindactilie sindactilie that compromise hand function. Amputation of thumb, crooked foot, cleft palate also require reconstruction, but these procedures can be performed later.
For 3D ultrasound identified bands that cause neurovascular compromise can be made early intrauterine surgery.Early intervention for severe postpartum constriction bands include excision with 2 mm strip of normal skin tissue to prevent recurrence. The whole band requires excision.This is done for 65% of the length Z and the plastic strip by strip closer to or VY plasty in W. A staged excision ensure adequate blood supply for the remaining member.In acrosindactilie separate fingers, especially if the bands do not affect blood flow.Fingers are separated when the child is between 6 months and 1 year. Prepare autolloga skin grafts. Reconstruction is performed. Despite improving cosmetic deformity will continue to be rigid fingers.
Prognosis:The prognosis depends on the location and severity of constriction bands. Each case is different and multiple bands can be wrapped around the fetus. Bands that wrap fingers cause sindactilie or amputations. In other cases bands can wrap around limbs causing limitation of movement with crooked legs. In more severe cases can cause blood loss and amputation intake. Amniotic bands may be attached to the face and neck causing deformities such as cleft lip or palate. If bands are wrapped around the head or umbilical cord can be life threatening for the fetus.