“…The ADAM sequence occurs in 1 in 1,200–15,000 in live births [1, 5, 6] and 1 : 70 in stillbirths [7]. It affects both genders in the same proportion.…”
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM “sequence,” in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation. Urgent surgery was performed, after which the newborn was transported to the ICU and intubated under controlled mechanical ventilation. The patient died a week later. The principles of beneficence, nonmaleficence, justice, and respect for autonomy are simultaneously an inspiratory and regulatory framework for clinical practice. Although only necessary procedures are defended, which suggests a position contrary to invasive interventions at the end of life, sometimes they are the best palliative measures that can be taken in cases like the one described here.
“…The ADAM sequence occurs in 1 in 1,200–15,000 in live births [1, 5, 6] and 1 : 70 in stillbirths [7]. It affects both genders in the same proportion.…”
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM “sequence,” in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation. Urgent surgery was performed, after which the newborn was transported to the ICU and intubated under controlled mechanical ventilation. The patient died a week later. The principles of beneficence, nonmaleficence, justice, and respect for autonomy are simultaneously an inspiratory and regulatory framework for clinical practice. Although only necessary procedures are defended, which suggests a position contrary to invasive interventions at the end of life, sometimes they are the best palliative measures that can be taken in cases like the one described here.
“…Fetal exposure to the fiber bands caused by rupture of amniotic membranes could lead to the division and developmental malformations of the affected organs, which are also considered as the causes of the atypical facial cleft. 5 Thus, patients with amniotic band syndrome often have severe deformities in other regions besides the maxillofacial region.…”
Section: Discussionmentioning
confidence: 99%
“…1 Such multidisciplinary treatment has dramatically improved survival, increasing the overall 5-year survival rate for ES for all sites from 10% to 50% to 70% over the past 20 years. 1,5 Although the prognosis of head and neck ES is similar to or better than that of ES arising in the other anatomic sites such as the extremities, 5,6,9 patients with metastatic disease still have poor prognosis. 10 Although the cell of origin of ES is not yet known, the molecular genetics of the tumor are better understood.…”
The maxillofacial region develops during 3 to 8 weeks in an embryo. The process involves neural crest cell migration and proliferation as well as facial protrusion jointing and fusion. The maxillofacial region is one of the predilection sites of congenital malformations. We treated a 5-year-old Chinese boy with abnormal development of the left maxillofacial region. We describe in detail the patient's characteristics, diagnosis, and treatment processes and try to explain the possible causes of the disease.
“…Forty-nine cases (27 males and 22 females) of oro-facial anomalies associated with amniotic band syndrome were reported in the literature over the past 20 years [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. These cases included 37 cases of facial cleft and 9 cases of cleft lip and palate.…”
Section: Discussionmentioning
confidence: 99%
“…This syndrome is a sporadic condition and is reported to occur in approximately 1 in 1,200-15,000 births [1][2][3][4][5]. The patient may present with craniofacial, thoracic, abdominal, and/or limb involvement.…”
The patient was a 5-day-old boy born at 37 weeks and 4 days. At birth, an amniotic band encircling and constricting his left middle finger was noted, in addition to multiple anomalies including a right-side cleft lip and palate, a club foot, and syndactyly on the left hand. We performed cheiloplasty at 5 months, and palatoplasty at 18 months.
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