Amniotic breech syndrome is a very rare condition, but with high risks to the healthy development of the baby. pregnancy As a result, these cords or bridles wrap around the child's limbs (fingers, arms, legs, neck, head, etc.) and compress the area, causing deformity and even amputation of the affected region.

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What are amniotic bridles?

First, before we talk about amniotic band syndrome, we need to explain what amniotic bridles are. We enlist the help of Dr. Emybleia De Meneses Amedi gynecologist at State Public Servant Hospital (HSPE) .

According to the expert, amniotic bridles are fibrous cords that adhere to fetal parts and can cause deformities in any part of the baby.

So, to better understand, it is important to point out that babies develop inside a sac composed of amniotic fluid and membranes that surround it and keep it closed for fetal protection. In some rare cases, these membranes can generate adhesions, that is, they can attach themselves to the baby, the so-called amniotic bridle that causes amniotic band syndrome.

What is amniotic band syndrome?

The gynecologist consulted explains that amniotic band syndrome is a congenital condition that can result in various body defects, such as limb amputation, craniofacial deformities, and fetal organ abnormalities, among others.

"The occurrence is rare and the incidence is estimated to be about 1:1,200 to 1:15,000 live births," he adds.

Causes of amniotic brida syndrome

According to gynecologist and obstetrician Alexandre Pupo, there is no cause for the appearance of amniotic brushes, but the specialist explains the process that triggers the syndrome: "The bag that houses the baby is formed by the amniotic membrane, which has another bag, the chorionic membrane. When the latter loosens, the brushes that affect the child are formed", he explains.

Although there is no medical consensus for the development for amniotic bridles, it is believed that it occurs when the membrane amniotic The breech ruptures and bursts, but the chorionic membrane remains intact, so the breech loosens and can wrap the baby's limbs.

Consequences of amniotic bride syndrome

The anomalies caused by amniotic band syndrome are asymmetrical and varied, so they do not follow any pattern of development. Therefore, the most common changes in babies impacted by this syndrome include:

• fingers sticking together;
• congenital clubfoot;
• shorter arms or legs;
• nail malformations;
• Amputation of the hand on one arm;
• amputated arm or leg;
• cleft palate or cleft lip.

Pupo explains that the condition is more serious when the bristles or bands manifest themselves in the first trimester of pregnancy, when the baby is still an embryo.

"In this period, the bridles can impact on organ formation and healthy growth of the baby in general, such as a malformation in the brain leading to a possible abortion. If the bands appear after the third month of life, the 'constriction rings' can cause deformities such as crooked feet and arms, limb asymmetry, kidney problems, dislocations and amputations," warns the specialist. In addition,the child can be born with a cleft palate if banding involves the head area.

Furthermore, there are some cases in which an abortion can happen, especially when the band, or amniotic bridle, forms around the umbilical cord This prevents the blood from flowing to the entire fetus.

Diagnosis

At first, the prenatal ultrasound is able to identify the condition, which is asymptomatic, that is, the mother does not feel any discomfort that signals the problem, although some women report episodes of bleeding.

"In many cases it is possible to see the areas affected by the band amniotic Thus, more serious malformations that can interrupt the baby's life or cause the loss of limbs can be avoided," adds Pupo, who highlights the importance of early diagnosis.

Treatment of amniotic band syndrome

Finally, there are several techniques that can be used according to the problem to be treated and the associated risks:

• Surgery to correct sticking fingers and other malformations in the baby's body;
• Use of prosthetics to correct missing fingers or parts of the arm and leg;
• Plastic Surgery to correct changes in the face, such as cleft lip;

These resources can save the child's life and repair the syndrome and the lack of oxygenation in the limbs caused by it. "For example, fetal surgery is a subspecialty of obstetrics and fetal medicine, done through a procedure called fetoscopy", suggests Alexandre Pupo. For the procedure, which resembles a "microlaparoscopy", the doctor inserts laparoscopy equipmentThe intervention is minimally invasive and can be done at any time during pregnancy, and is most successful if done as early as possible.

In addition, if the baby is born with congenital clubfoot, the pediatrician may advise doing the Ponseti technique, which consists of putting a cast on the baby's foot every week for 5 months.

Then the doctor will advise wearing orthopedic boots until the age of 4, correcting the change in the feet without the need for surgery.

Frequently asked questions about amniotic band syndrome

Can the baby die if there is no treatment?

Yes, especially in the first months of life, which are crucial for the child's integral formation. Febrasgo reinforces the relevance of prenatal care to discover any unforeseen problems before they irreversibly harm the baby.

Can I prevent the syndrome?

Unfortunately there is no way to prevent the condition, because the common denominator to the cause is not known.

Can I get amniotic brida syndrome in every pregnancy?

The probability of assuming a pregnancy with the same syndrome is minimal, and there are no similar cases reported by science. After all, it is unlikely that the condition is associated with genetic or hereditary issues.

Source: Alexandre Pupo, gynecologist and obstetrician at Hospital Sírio-Libanês and Albert Einstein.

Dr. Emybleia De Meneses Amedi, gynecologist at Hospital do Servidor Público Estadual (HSPE).