Upper limb ischemia at birth
A case report from Saudi Arabia
Keywords:
amniotic band syndrome, gestational diabetes, intrauterine limb ischemia, maternal diabetes, neonatal limb ischemiaAbstract
The aim of this case report: is to present and discuss the clinical features, diagnostic challenges, management strategies, and outcomes of two cases involving upper limb ischemia in neonates. By examining these cases, we aim to contribute to the understanding of the underlying causes, diagnostic pathways, and potential interventions for neonates presenting with upper limb ischemia, emphasizing the importance of early diagnosis and appropriate management to minimize complications and enhance patient outcomes. Discussion Summary: ABS presents a range of fetal abnormalities caused by fibrous bands in the womb, leading to deformities and developmental interruptions. Limb constriction rings are common, potentially resulting in limb loss or digit deformities. Neonatal limb ischemia, particularly acute limb ischemia, is rare but associated with catheterization. In utero compression ischemia, often affecting the brachial artery, can lead to limb ischemia. Risk factors include maternal conditions like diabetes, dehydration, and more. Proper delivery planning is crucial for macrosomic infants. Diagnosis and management of neonatal limb ischemia are challenging. Doppler ultrasound is the primary diagnostic tool, with fetal CT enhancing prenatal assessment. Thrombolytic therapy, including alteplase and heparin, is a common treatment.
Downloads
References
Andrew, T., Hart, D. J., Snieder, H., De Lange, M., Spector, T. D., & MacGregor, A. J. (2001). Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Research and Human Genetics, 4(6), 464-477.
Arshad, A., & McCarthy, M. J. (2009). Management of limb ischaemia in the neonate and infant. European Journal of Vascular and Endovascular Surgery, 38(1), 61-65. https://doi.org/10.1016/j.ejvs.2009.03.010
Baker, C. J., & Rudolph, A. J. (1971). Congenital ring constrictions and intrauterine amputations. American journal of diseases of children, 121(5), 393-400.
Bower, S., Schuchter, K., & Campbell, S. (1993). Doppler ultrasound screening as part of routine antenatal scanning: prediction of pre‐eclampsia and intrauterine growth retardation. BJOG: An International Journal of Obstetrics & Gynaecology, 100(11), 989-994.
Carr, M. M., Al-Qattan, M., & Clarke, H. M. (1996). Extremity gangrene in utero. Journal of Hand Surgery, 21(5), 652-655.
Chandrasekaran, A. R. (2021). Nuclease resistance of DNA nanostructures. Nature Reviews Chemistry, 5(4), 225-239.
Çöloğlu, H., Özkan, B., Çöloğlu, Ö., Yalçınkaya, C., Uysal, A. Ç., & Borman, H. (2014). Salvage surgery of the limb with severe pseudoamniotic band syndrome: case report and literature review. Handchirurgie• Mikrochirurgie• Plastische Chirurgie, 46(02), 121-124.
Dandurand, M., Michel, B., Fabre, C., Stoebner, P., & Meunier, L. (2009). Syndrome de Volkmann néonatal. In Annales de Dermatologie et de Vénéréologie (Vol. 136, No. 11, pp. 785-789). Elsevier Masson. https://doi.org/10.1016/j.annder.2009.01.018
Gandhi, M., Rac, M. W., & McKinney, J. (2019). Amniotic band sequence. American Journal of Obstetrics & Gynecology, 221(6), B5-B6.
Haase, R., & Merkel, N. (2008). Postnatal femoral artery spasm in a preterm infant. The Journal of pediatrics, 153(6), 871.
Lamrissi, A., Mourabbih, M., Ouajih, O., Jalal, M., Fichtali, K., & Bouhya, S. (2022). Amniotic band syndrome: A case report. International Journal of Surgery Case Reports, 95, 107096. https://doi.org/10.1016/j.ijscr.2022.107096
Ma, S. G., Yu, W. N., Jin, Y., Hong, B., & Hu, W. (2012). Evaluation of serum ischemia-modified albumin levels in pregnant women with and without gestational diabetes mellitus. Gynecological Endocrinology, 28(11), 837-840.
Manco-Johnson, M. J., Grabowski, E. F., Hellgreen, M., Kemahli, A. S., Massicotte, M. P., Muntean, W., ... & Nowak-Göttl, U. (2002). Laboratory testing for thrombophilia in pediatric patients. Thrombosis and haemostasis, 88(07), 155-156.
Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., Fowkes, F. G. R., & Tasc II Working Group. (2007). Inter-society consensus for the management of peripheral arterial disease (TASC II). Journal of vascular surgery, 45(1), S5-S67. https://doi.org/10.1016/j.jvs.2006.12.037
Nowak-Göttl, U., Junker, R., Kreuz, W., von Eckardstein, A., Kosch, A., Nohe, N., ... & Ehrenforth, S. (2001). Risk of recurrent venous thrombosis in children with combined prothrombotic risk factors. Blood, The Journal of the American Society of Hematology, 97(4), 858-862.
Özgenel, G. Y., Akin, S., Uysal, A., Köksal, N., & Özcan, M. (2000). Gangrene of the upper extremity in the newborn. European Journal of Plastic Surgery, 23, 429-431.
Ragland III, R., Moukoko, D., Ezaki, M., Carter, P. R., & Mills, J. (2005). Forearm compartment syndrome in the newborn: report of 24 cases. The Journal of hand surgery, 30(5), 997-1003. https://doi.org/10.1016/j.jhsa.2005.06.003
Romero-Valdovinos, M., Bobadilla-Sandoval, N., Flisser, A., & Vadillo-Ortega, F. (2014). The epithelial mesenchymal transition process may contribute to the pathogenesis of amniotic band syndrome. Medical Hypotheses, 83(3), 306-311. https://doi.org/10.1016/j.mehy.2014.06.002
Roy, M., Turner-Gomes, S., Gill, G., Way, C., Mernagh, J., & Schmidt, B. (2002). Accuracy of Doppler echocardiography for the diagnosis of thrombosis associated with umbilical venous catheters. The Journal of pediatrics, 140(1), 131-134. https://doi.org/10.1067/mpd.2002.119591
Schmidt, B., & Andrew, M. (1995). Neonatal thrombosis: report of a prospective Canadian and international registry. Pediatrics, 96(5), 939-943.
Seeds, J. W., Cefalo, R. C., & Herbert, W. N. (1982). Amniotic band syndrome. American journal of obstetrics and gynecology, 144(3), 243-248. https://doi.org/10.1016/0002-9378(82)90574-9
Sentilhes, L., Verspyck, E., Patrier, S., Eurin, D., Lechevallier, J., & Marpeau, L. (2003). Maladie des brides amniotiques: etiopathogeniè, diagnostic antenatal et prise en charge neonatale. Journal de gynécologie obstétrique et biologie de la reproduction, 32(8), 693-704.
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864
Torpin, R. (1965). Amniochorionic mesoblastic fibrous strings and amnionic bands: associated constricting fetal malformations or fetal death. American Journal of Obstetrics and Gynecology, 91(1), 65-75. https://doi.org/10.1016/0002-9378(65)90588-0
Turnpenny, P. D., Stahl, S., Bowers, D., & Bingham, P. (1992). Peripheral ischaemia and gangrene presenting at birth. European journal of pediatrics, 151, 550-554.
Van Elteren, H. A., Veldt, H. S., Te Pas, A. B., Roest, A. A. W., Smiers, F. J., Kollen, W. J., ... & Lopriore, E. (2011). Management and outcome in 32 neonates with thrombotic events. International Journal of Pediatrics, 2011.
Wang, S. K., Lemmon, G. W., Drucker, N. A., Motaganahalli, R. L., Dalsing, M. C., Gutwein, A. R., ... & Murphy, M. P. (2018). Results of nonoperative management of acute limb ischemia in infants. Journal of vascular surgery, 67(5), 1480-1483. https://doi.org/10.1016/j.jvs.2017.09.036
Weinzweig, N. (1995). Constriction band-induced vascular compromise of the foot: classification and management of the “intermediate” stage of constriction-ring syndrome. Plastic and reconstructive surgery, 96(4), 972-977.
Winer, R. L., Feng, Q., Hughes, J. P., O'Reilly, S., Kiviat, N. B., & Koutsky, L. A. (2008). Risk of female human papillomavirus acquisition associated with first male sex partner. The Journal of infectious diseases, 197(2), 279-282.
Published
How to Cite
Issue
Section
Copyright (c) 2024 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.