thumb The diagnosis of<unk>  can be confirmed with an ultrasonography. The clinical manifestations can be extremely variable. It could be a single or multiple manifestation. This can be confirmed at the end of the first trimester or at the beginning of the second trimester. But not every patient will be diagnosed at that moment, most will get this diagnosis at birth. Individual strands are small and hard to see on ultrasound, so bands are detected indirectly because of the<unk> s and swelling upon limbs or digits. Misdiagnosis is also common, so if there are any signs of amniotic bands, further detailed ultrasound tests should be done to assess the severity. 3D ultrasound and MRI can be used for more detailed and accurate diagnosis of bands and the resulting damage/danger to the fetus. Decreased fetal movement could be a sign of a serious problem which may include ABS. It is rare but possible for the membrane to become wrapped around the placenta or the neck of the baby in the womb causing strangulation and death. There is a strong relationship between ABS and clubfoot (also called "talipes"). 31.5% of clubfoot cases can be correlated with ABS, with 20% occurring bilaterally. Other abnormalities found with ABS include: clubhands, cleft lip, and/or cleft palate, and hemangioma. Differential diagnosis The differential diagnosis includes: * Symbrachydactyly * Congenital amputations * Hypoplasias of hand, digit, thumb * Adams–Oliver syndrome * ADAM complex ADAM Complex; CRS is sometimes mislabeled as ADAM complex. ADAM is an abbreviation for Amniotic Deformity, Adhesions Mutilations. CRS is the malformation due to a<unk> <unk>  around mostly a limb. ADAM-complex is the association of limb defects (caused by<unk> <unk> s) and certain craniofacial clefts "Adams–Oliver syndrome is often mislabeled as CRS and consists of cutis aplasia of the scalp in which a longitudinal defect can vary in size and can often be associated with full-thickness skullcap loss. The distal digital or toe hypoplasia-aplasia is often confused with CRS.<unk> <unk> s with or without edema are not present. The digital or toe hypoplasia-aplasia usually contains diminutive nails or nail folds". Classification The<unk>  is a complex collection of asymmetric congenital anomalies, in which no two cases are exactly alike. This is why a classification is difficult to make. The most widely used classification system was proposed by Patterson. This classification system is based on the severity of the syndrome and is useful because, the different types require different treatments. Other clinicians have amended this scheme by separating the depth of the<unk>  into mild, moderate, severe, and amputation and by further defining the presence or absence of lymphedema or soft tissue loss distal to the<unk> . Expanding over subdivision in depth of the clefts for every classification is not necessary because the principles of treatment and technique for correction are the same. There are four categories: # simple<unk> <unk> s #<unk> <unk> s associated with deformity of the distal part with or without lymphedema #<unk> <unk> s associated with acrosyndactyly # uterine amputation Patterson divided the<unk> <unk>  associated with acrosyndactyly into three types: * Type I: conjoined fingertips with well-formed webs of the proper depth * Type II: the tips of the digits are joined, but web formation is not complete * Type III: joined tips, sinus tracts between digits and absent webs ;Patterson I There are simple<unk> <unk> s which are strands most commonly around the distal extremities as fingers and toes. In general, the thumb is not likely to be affected by a<unk> <unk>  because the fetus typically holds the thumb in tight adduction flexion, making entanglement with strands less likely. These malformations need to be surgically removed which must be executed in different stages and can done by different techniques (see also treatment). ;Patterson II The CRS involves strands which obstruct the lymphatic vessels and thus causing fluid retention, distal of the affected extremity. This utters itself with swollen parts distal of the<unk> . ;Patterson III In this form there is a complex form of syndactyly named acrosyndactyly, the fingers (or toes) were initially separated but due to the<unk>  they are formed back together. Sometimes multiple fingers can be involved. The distal fusion between digits or toes never initially involves a skeletal coalition. The digits are usually hypoplastic if multiple digits are involved. When the<unk>  cuts off the blood supply to the fingers, the fingers can form a peak with the most palmar digit being the index finger. Normal neurovascular bundles are not present in the distal parts. Hands with fused fingers need to be released in phases to preserve the distal blood supply. ;Paterson IV One of the most severe consequence of<unk>  strains is probably intrauterine amputations, this is where the<unk>  goes as deep as the bone and cuts off the blood supply of the proximal extremity. The result will be that the developing toe or finger will become ischemic and fall off. Because the end result is a transverse amputation that cuts off the vascular supply to the developing extremity, the actual<unk> <unk>  is not seen. This can result in different outcomes: * complete resorption; this is the most common form of amputation. In this form the amputated digit is completely resorbed during intrauterine development and therefore the amputated digit can't be found. * recovery of the digit; the digit is recovered with the placenta during delivery. * engraftment elsewhere; the amputated digit can be, in rare cases, engrafted somewhere on the fetus. ;Intrauterine death In extremely rare cases a strain can form around the umbilical cord and cut off the blood supply to the fetus which will result in intrauterine death. ;Malformation associated with<unk>  The percentage of associated anomalies varies from 40% to as high as 80%<unk> <unk>  deformities are as common on the lower extremity as on the upper, almost all of these involve the musculoskeletal system, with clubbed feet being the most common in up to 30% of reported cases. Large reported series reveal an incidence between 5% and 15% of craniofacial malformations with clefting of the lip or palate.
Constriction ring syndrome
Jordans' anomaly
Saal Greenstein syndrome
Ebstein's anomaly
Spigelian hernia
Situs inversus
Intersection syndrome
Heerfordt syndrome