Which pregnancy history findings are characteristic of arthrogryposis multiplex congenita (AMC)?

Updated: Nov 11, 2020
  • Author: Mithilesh Kumar Lal, MD, MBBS, MRCP, FRCPCH, MRCPCH(UK); Chief Editor: Maria Descartes, MD  more...
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Infants born to mothers affected with myotonic dystrophy, myasthenia gravis, or multiple sclerosis are at risk. A mother with congenital myotonic dystrophy may have a child who inherits the gene and is severely affected with resistant contractures. A mother with myasthenia gravis or multiple sclerosis can have children with congenital contractures.

Maternal infections (rubella, rubeola, coxsackievirus, enterovirus) can lead to CNS or peripheral nerve destruction with secondary congenital contractures. Protracted or severe nausea may suggest maternal viral infection or encephalitis.

Maternal fever of more than 39°C for an extended period or maternal hyperthermia can cause contractures due to abnormal nerve growth or migration. This can be caused by prolonged soaking in hot tubs or hot baths.

Exposure to teratogens, such as drugs, alcohol, curare, methocarbamol, and phenytoin, may lead to decreased fetal movement.

Oligohydramnios or chronic amniotic fluid leakage may cause fetal constraint and secondary deformational contractures. Polyhydramnios may suggest fetal compromise (ie, defect in swallowing) and is a poor prognostic sign if associated with fetal hydrops.

Ask about uterine abnormalities such as bicornuate uterus with a septum or uterine fibroid.

Ask if the mother had large fibroids or other tumors, severe hypotension at a critical time, or severe hypoxia (eg, carbon monoxide poisoning) during pregnancy.

Review abnormal fetal movements such as decreased fetal movements, fetal kicking in one place, and decreased rolling.

Other complications that may be related to contractures include bleeding, abnormal fetal lies, threatened abortion, attempted termination, and trauma, such as a blow to the abdomen. An abnormal fetal lie may be a clue to intrauterine joint contractures.

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