"Is the deformation of the baby's hands and feet due to entanglement by the amniotic bands caused by the umbilical cord? "
"Are amniotic bands the same as the umbilical cord?"
……
I often see similar questions in my comments or private messages.
In fact, this situation is not due to the baby being "choked" by the umbilical cord in the womb, but rather by the entanglement of amniotic bands.
Are amniotic bands a serious issue?
This type of wrapping often occurs at the distal ends of the limbs, such as fingers, toes, forearms, or calves, causing ischemia and potentially leading to necrosis, especially if it happens very distally. Even with ultrasound, it can be difficult to observe clearly.
Amniotic bands can significantly impact limb development, similar to an injury, and may lead to amputations or webbing of fingers. Therefore, the most crucial issue after diagnosis is to perform surgery as soon as possible to release the bands.
Arm amniotic band
When is the appropriate time for surgery?
The best timing for surgery depends on the child's specific condition and cannot be generalized. It is typically categorized into three stages: immediately after birth, around 3 months, or around 6 months.
If the amniotic bands are wrapped severely, emergency surgery is required to prevent limb necrosis. Even in very young children, the risks must be taken.
If the entanglement is less severe, surgery can be delayed until around 3 or 6 months.
Comparison of emergency surgery for amniotic band three days after birth
How many surgeries are needed?
The number of surgeries required varies for each child, but the principle is to minimize both the duration and frequency of surgeries.
Multiple surgeries can extend recovery time for the child and create a greater burden for the parents. Therefore, efforts are made to combine surgeries when possible, such as releasing the bands and releasing webbing fingers or flexion contracture.
However, if a single surgery cannot resolve all issues, a two-step approach may be considered.
For example, in cases of severe webbing due to amniotic bands, blood circulation to the fingers may be significantly affected, necessitating stepwise release and reconstruction to ensure reliable blood flow.
Preoperative assessment is essential, which is why children must first consult at the outpatient clinic. By understanding the child's condition, we can develop an appropriate surgical plan.