Abstract Ref Number = APCP1011
AMNIOTIC BAND SYNDROME IN INFANT WITH EXTREMELY LOW BIRTH WEIGHT
Deska Andina Rezki,Isra Firmansyah
Department of Child Health Syiah Kuala University Dr Zainoel Abidin Hospital Banda Aceh Indonesia Department of Child Health, Faculty of Medicine Syiah Kuala University DrZainoel Abidin Hospital, Banda Aceh, Indonesia
Background : Amniotic band syndrome (ABS) is a rare congenital disorder that is caused by the entrapment of various fetal parts with fibrous amniotic bands in utero. Every part of the fetal body can be damaged, but most often extremities, such as constriction rings or digiti amputations.
Case Presentation Summary : We report a case of amniotic band syndrome with extremely low birth weight premature infant at Dr. Zainoel Abidin Hospital, Banda Aceh. A baby boy, birth weight was 600 grams, gestational age was 24-26 weeks, spontaneously born from mothers with early amnion rupture one week before and hepatitis B positive. The baby was born weak, did not immediately cry, Apgar Score was 5/6, Downe Score was 6 with congenital anomaly. In the upper extremity, the right hand appears only with 3 fingers, digiti II and III shortened and syndactyly, left hand only with 2 fingers, digiti II, III, and VI shortened and fused. Lower limb, right leg was necrotic, left leg with digiti II and III syndactyly. Patients was got phytomenadion and hyperheb injection and decided to treated in NICU with CPAP and got total parenteral nutrition. The patient has been consulted to the plastic surgery and was amputated at regio cruris dextra 1/3 medial, also he got an early screening related to developmental risk delay for preterm infant such us congenital hypothyroid, ROP, and otoacoustic emission test. After 2 months of treatment, the patient returns with stable condition, body weight has 1700 grams.
Learning Points/Discussion : There are various theories to explain ABS. The most accepted one is premature rupture of membrane with amniotic band formation causing compression and ischemia of fetal parts. Incidence of ABS is estimated in wide range of 1:1200 – 1:15000 live births. Treatment and follow-up of this patient requires comprehensive care by a team of specialist from multiple disciplines.
Keywords: Amniotic band syndrome extremely low birth weight amputated extremities premature rupture of membranes