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Amniotic band resection is an experimental fetal surgery used to treat rare, severe cases of amniotic band syndrome (ABS), a congenital condition that can cause life-threatening and limb-threatening birth defects and deformities.
ABS occurs when the lining of the amniotic sac, the fluid-filled sac that holds the baby, ruptures or tears, producing string-like strands or “bands” of tissue that can wrap around parts of the developing fetus.
These amniotic bands can decrease or cut off blood supply to the affected areas, most commonly the arms, legs, fingers and toes, causing birth defects ranging from minor deformities to complete limb amputations. The head, internal organs and umbilical cord can also be affected, with severe, sometimes life-threatening complications.
When is Amniotic Band Resection performed?
In the majority of cases, treatment of ABS occurs after birth and involves surgery to repair congenital deformities.
In rare cases involving life-threatening or severe damage to the fetus, fetal surgery may be an option. The goal of fetal intervention is to release the constriction caused by the amniotic bands to prevent further damage.
The experimental procedure, known as fetoscopic amniotic band resection, is reserved for cases where the bands are:
- Constricting the umbilical cord and threatening the life of the fetus
- Cutting off the blood supply to a limb and threatening amputation
- Threatening to cause severe deformity
About the Procedure
In fetal amniotic band resection, the mother is sedated and given antibiotics and medications to help prevent labor. The fetus may also be sedated.
The surgeon makes a small incision in the mother’s abdomen and uterus. Guided by ultrasound imaging, the surgeon inserts a tiny tube with a camera at the tip, known as a fetoscope, into the uterus.
Using surgical instruments or a laser, the surgeon then cuts the band or bands that are endangering the fetus, freeing the constricted body part to prevent further damage to the fetus.
Risks
This minimally invasive surgery may allow preservation of life and/or limb in babies with amniotic band syndrome. Doctors are still studying which cases of ABS benefit most from in-utero treatment.
Fetoscopic amniotic band resection involves significant risks, including premature delivery, bleeding, and damage to the fetus. Talk with your health care team about the risks involved to help you make the most informed decision for you and your family.
After the Procedure
After amniotic band resection, the mother remains in the hospital until she is stable. Mother and fetus are monitored closely throughout the remainder of the pregnancy, with additional ultrasounds and testing as needed. Babies are typically carried to term and delivered vaginally.
Immediately after birth, the baby is examined to determine additional treatment needs. Treatment may include reconstructive and plastic surgery to repair deformities caused by the constrictive bands, and physical and occupational therapy to help the child optimize the use of affected limbs. Prosthetics may be recommended for children who have lost a limb or limb functionality.
In some cases, your baby may be referred to specialized clinics for surgical expertise, such as Texas Children’s Hand Program or Texas Children’s Cleft Lip and Palate Clinic.
Research and Clinical Trials
Volumes and Outcomes
View data on our experience and outcomes treating amniotic band syndrome
Why Texas Children’s Fetal Center?
Texas Children’s Fetal Center is one of the oldest and most experienced programs in the nation, with a history of leading the development and implementation of innovative fetal therapies and procedures. Our multidisciplinary team of experts is dedicated to providing new evidence-based options to patients and families facing rare congenital birth defects such as amniotic band syndrome.
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