Friday, September 12, 2008

History of ABS

I was given an article from eMedicine by Dr. Oppenheim last week and found it interesting and somewhat amusing. Interesting was the history of Amniotic Band Syndrome and the various hypotheses on how it happens. Thankfully most people agree that it is not something that can be passed on to the child and it's for sure not genetic (we had testing) and it doesn't appear to be caused by a vitamin deficiency or harmful substance (medication, etc.). What it seems is the most common cause is maternal trauma. Something happened to the amniotic sac that damaged it, weakening it and causing the sticky strands of tissue to wrap around her limbs and head. One strand or band was still wrapped around her hand when she was born if I remember correctly. The weird thing is that the only two things I can think of are my running during pregnancy (but many, many people run their first trimester and are fine) and the Dumbo ride at Disneyland. It sounds so funny but I went on that ride when I was at Disneyland during the weeks that the doctors speculate it happened (they can tell due to the development I guess). My OB scolded me for going on the ride but I laughed. Seriously, I doubt it was the Dumbo ride. :) All I know is that whether or not it was Dumbo that did it I am certain that God allowed it and therefore I'm okay with it. :)
Here' s part of the article...notice the italicized part...I was laughing out loud.

Streeter dysplasia is a term used to describe a complex disorder characterized by constricting rings, acrosyndactyly, or, often, amputations of the extremities of neonates. It is analogous to constriction band or amniotic band syndrome (ABS), which was recognized as early as 300 BC. Hippocrates suggested that extrinsic pressures from a ruptured amniotic membrane lead to the formation of bands or digital amputations. In 1652, J.B. van Helmont reported on intrauterine amputations, which he attributed to the pregnant mothers having looked upon maimed soldiers. Montgomery in 1832 and Simpson in 1836 subsequently described series of amniotic band–associated deformities and discussed the differences between agenesis- and amniotic band–induced amputations.
The term "Streeter dysplasia" did not come into use until 1930, when George Streeter postulated a germ plasm defect as one plausible etiology. At that time, his theory was well accepted because of the associated anomalies, which occurred far from the site of the constriction bands. In 1960, Patterson used histology to show how constriction bands looked like normal skin creases. He hypothesized that the same lack of mesodermal development occurs in the area of the band, thereby making the bands simply abnormal creases.
Patterson's theory was later refuted by Richard Torpin, who examined many placentae and infants with the disorder. In 1965, he reintroduced the idea originally held by Hippocrates. He proposed that maternal trauma led to rupture of the amniotic membrane, which then formed into strands. These encircling strands cause extrinsic compression on the head or limb, leading to the formation of bands, vascular occlusion, and, eventually, amputations. Currently, this is the most widely supported hypothesis; therefore, this disorder would be more accurately termed ABS.


Chiara said...

Jen--I love how you say it was the Dumbo ride, but because God allowed it, I'm okay with it. So true!

Jennifer Gray said...

Chiara - It reminds me of Steven Churtis Chapman to a caller on Larry King. The caller was wanting to get a ban on SUVs because of the number of children who are run over by them (Steven's daughter was recently run over by their own SUV). Steven's response was that in doing that we are saying SUVs are sovereign over events in this life. Instead we need to realize it's God who is in control of all things, not SUVs. We'll never know if it was the Dumbo ride (I'm assuming it was not) but we do know it was God who allowed it. Thanks for always posting comments here. :) Jen