Deformations and Disruptions

A structural abnormality or anomaly may be a malformation, deformation, or disruption. Deformations and disruptions are the result of mechanical forces affecting normal tissue, while malformations are the result of a primary problem in morphogenesis. A deformation is a physical change in form, shape, or position caused by mechanical forces secondary to restricted intrauterine motion (e.g., clubfoot secondary to constraint of the foot). Most of these have an excellent prognosis once the fetus is released from the constraining environment. In some instances, application of an opposite force may be needed to correct the deformation. Some deformations are caused by a problem intrinsic to the fetus and are not reversible (clubfoot secondary to neuromuscular disorder). A clear distinction between deformation and malformation is important when educating parents on prognosis, management and recurrence risk. A disruption is a congenital defect resulting from an extrinsic interference with an originally normal developmental process (e.g., abnormality caused by an amniotic band). Disruptions usually result in cell death and are not correctable.

DEFORMATIONS (Congenital Postural Deformities, "Position-of-Comfort" Anomalies) and DISRUPTIONS (Amniotic band disruption complex-The Early Amnion Rupture Spectrum (TEARS))

Autoamputation of digits, furrows due to amniotic bands, and syndactyly may develop between the affected digits. Amniotic bands may cause major disruptions that lead to constriction or amputation or to craniofacial disruption. Lack of symmetry of the lesions differentiate disruption caused by amniotic bands from genetic causes of craniofacial or limb anomalies.

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