Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1994 Nov;31(11):823–829. doi: 10.1136/jmg.31.11.823

Diagnostic distinction between anencephaly and amnion rupture sequence based on skeletal analysis.

J W Keeling 1, I Kjaer 1
PMCID: PMC1016652  PMID: 7853363

Abstract

The axial skeletal development of eight second trimester aborted fetuses, clinically diagnosed as amnion rupture sequence with cranial involvement, was examined radiographically and histologically. Three of the eight fetuses showed axial skeletal malformation in the spine and the craniofacial skeleton corresponding to the malformations seen in anencephaly. These are vertebral body malformations, consisting of double corpora and of osseous malformations in the components of the cranial base, the corpus of the occipital bone, and the postsphenoid bone. These types of malformation, which have previously been described, are located along the original course of the notochord. The findings show that it is possible by means of radiography of the axial skeleton to distinguish between anencephalic fetuses which become secondarily involved in amnion rupture and fetuses which were initially normally developed. The method supplements detailed fetal examination and provides important information for genetic counselling.

Full text

PDF
823

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bamforth J. S. Amniotic band sequence: Streeter's hypothesis reexamined. Am J Med Genet. 1992 Oct 1;44(3):280–287. doi: 10.1002/ajmg.1320440304. [DOI] [PubMed] [Google Scholar]
  2. Crosby J. L., Varnum D. S., Nadeau J. H. Two-hit model for sporadic congenital anomalies in mice with the disorganization mutation. Am J Hum Genet. 1993 May;52(5):866–874. [PMC free article] [PubMed] [Google Scholar]
  3. Donnai D., Winter R. M. Disorganisation: a model for 'early amnion rupture'? J Med Genet. 1989 Jul;26(7):421–425. doi: 10.1136/jmg.26.7.421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Goldstein R. B., Filly R. A. Prenatal diagnosis of anencephaly: spectrum of sonographic appearances and distinction from the amniotic band syndrome. AJR Am J Roentgenol. 1988 Sep;151(3):547–550. doi: 10.2214/ajr.151.3.547. [DOI] [PubMed] [Google Scholar]
  5. HUMMEL K. P. Developmental anomalies in mice resulting from action of the gene, disorganization, a semi-dominant lethal. Pediatrics. 1959 Jan;23(1 Pt 2):212–221. [PubMed] [Google Scholar]
  6. HUMMEL K. P. The inheritance and expression of disorganization, an unusual mutation in the mouse. J Exp Zool. 1958 Apr;137(3):389–423. doi: 10.1002/jez.1401370303. [DOI] [PubMed] [Google Scholar]
  7. Harrington B. J., Horger E. O., Edwards J. G. A counseling dilemma involving anencephaly, acrania and amniotic bands. Genet Couns. 1992;3(4):183–186. [PubMed] [Google Scholar]
  8. Heifetz S. A. Strangulation of the umbilical cord by amniotic bands: report of 6 cases and literature review. Pediatr Pathol. 1984;2(3):285–304. doi: 10.3109/15513818409022261. [DOI] [PubMed] [Google Scholar]
  9. Higginbottom M. C., Jones K. L., Hall B. D., Smith D. W. The amniotic band disruption complex: timing of amniotic rupture and variable spectra of consequent defects. J Pediatr. 1979 Oct;95(4):544–549. doi: 10.1016/s0022-3476(79)80759-3. [DOI] [PubMed] [Google Scholar]
  10. Hughes R. M., Benzie R. J., Thompson C. L. Amniotic band syndrome causing fetal head deformity. Prenat Diagn. 1984 Nov-Dec;4(6):447–450. doi: 10.1002/pd.1970040609. [DOI] [PubMed] [Google Scholar]
  11. Hunter A. G., Carpenter B. F. Implications of malformations not due to amniotic bands in the amniotic band sequence. Am J Med Genet. 1986 Aug;24(4):691–700. doi: 10.1002/ajmg.1320240414. [DOI] [PubMed] [Google Scholar]
  12. Kjaer I., Graem N. Simple autopsy method for analysis of complex fetal cranial malformations. Pediatr Pathol. 1990;10(5):717–727. doi: 10.3109/15513819009064707. [DOI] [PubMed] [Google Scholar]
  13. Kjaer I., Keeling J. W., Graem N. Midline maxillofacial skeleton in human anencephalic fetuses. Cleft Palate Craniofac J. 1994 Jul;31(4):250–256. doi: 10.1597/1545-1569_1994_031_0250_mmsiha_2.3.co_2. [DOI] [PubMed] [Google Scholar]
  14. Kjaer I. Ossification of the human fetal basicranium. J Craniofac Genet Dev Biol. 1990;10(1):29–38. [PubMed] [Google Scholar]
  15. Kjaer I. Prenatal human cranial development evaluated on coronal plane radiographs. J Craniofac Genet Dev Biol. 1990;10(4):339–351. [PubMed] [Google Scholar]
  16. Kjaer I. Prenatal skeletal maturation of the human maxilla. J Craniofac Genet Dev Biol. 1989;9(3):257–264. [PubMed] [Google Scholar]
  17. Kjar I. Skeletal maturation of the human fetus assessed radiographically on the basis of ossification sequences in the hand and foot. Am J Phys Anthropol. 1974 Mar;40(2):257–275. doi: 10.1002/ajpa.1330400211. [DOI] [PubMed] [Google Scholar]
  18. Lockwood C., Ghidini A., Romero R., Hobbins J. C. Amniotic band syndrome: reevaluation of its pathogenesis. Am J Obstet Gynecol. 1989 May;160(5 Pt 1):1030–1033. doi: 10.1016/0002-9378(89)90153-1. [DOI] [PubMed] [Google Scholar]
  19. Moerman P., Fryns J. P., Vandenberghe K., Lauweryns J. M. Constrictive amniotic bands, amniotic adhesions, and limb-body wall complex: discrete disruption sequences with pathogenetic overlap. Am J Med Genet. 1992 Feb 15;42(4):470–479. doi: 10.1002/ajmg.1320420412. [DOI] [PubMed] [Google Scholar]
  20. Quintero R. A., Romero R., Mahoney M. J., Vecchio M., Holden J., Hobbins J. C. Fetal haemorrhagic lesions after chorionic villous sampling. Lancet. 1992 Jan 18;339(8786):193–193. doi: 10.1016/0140-6736(92)90272-5. [DOI] [PubMed] [Google Scholar]
  21. Seeds J. W., Cefalo R. C., Herbert W. N. Amniotic band syndrome. Am J Obstet Gynecol. 1982 Oct 1;144(3):243–248. doi: 10.1016/0002-9378(82)90574-9. [DOI] [PubMed] [Google Scholar]
  22. TORPIN R. AMNIOCHORIONIC MESOBLASTIC FIBROUS STRINGS AND AMNIONIC BANDS: ASSOCIATED CONSTRICTING FETAL MALFORMATIONS OR FETAL DEATH. Am J Obstet Gynecol. 1965 Jan 1;91:65–75. doi: 10.1016/0002-9378(65)90588-0. [DOI] [PubMed] [Google Scholar]
  23. Urich H., Herrick M. K. The amniotic band syndrome as a cause of anencephaly. Report of a case. Acta Neuropathol. 1985;67(3-4):190–194. doi: 10.1007/BF00687800. [DOI] [PubMed] [Google Scholar]
  24. Van Allen M. I., Curry C., Gallagher L. Limb body wall complex: I. Pathogenesis. Am J Med Genet. 1987 Nov;28(3):529–548. doi: 10.1002/ajmg.1320280302. [DOI] [PubMed] [Google Scholar]
  25. Yang S. S. ADAM sequence and innocent amniotic band: manifestations of early amnion rupture. Am J Med Genet. 1990 Dec;37(4):562–568. doi: 10.1002/ajmg.1320370429. [DOI] [PubMed] [Google Scholar]
  26. Young I. D., Lindenbaum R. H., Thompson E. M., Pembrey M. E. Amniotic bands in connective tissue disorders. Arch Dis Child. 1985 Nov;60(11):1061–1063. doi: 10.1136/adc.60.11.1061. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES