Contributed by: Dr. Divya Agarwal  
  This 29 day-old female baby was referred for evaluation of hand and foot
anomalies noted since birth. She was born at term gestation and had a normal
birth weight. The feeding and activity were normal and there were no other
significant systemic complaints.

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Answer to PhotoQuiz 26
Amniotic band sequence (OMIM#217100)
Amniotic band sequence (amniotic rupture sequence) is a morphologic defect resulting from disruption i.e. interruption of the normal embryonic developmental process. Amnion rupture leads to formation of amniotic bands, which in turn results in a range of clinical manifestations from minor anomalies (constriction rings around the digits) to lethal anomalies (facial clefts, anencephaly, amputation of digits/arm/leg, joint contractures etc). Various theories have been proposed as the underlying cause including vascular anomalies to germ disc disruption. The reported incidence of amniotic band sequence is 1 in 1,200 to 1 in 15,000 live-births. Prognosis depends on the extent of involvement (digits to internal organs). Most cases are sporadic with no risk of recurrence, although there are few reports of familial occurrence.
Correct responses were given by:
1. Deepti Saxena, Lucknow
2. Rekha Goyal, Rajasthan
3. Subapriya K, Chennai
4. Prashanth Verma
5. Beena Suresh, Chennai