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

Updated: Jan 03, 2019
  • Author: Mithilesh K Lal, MD, MBBS, MRCP, FRCPCH, MRCPCH(UK); Chief Editor: Maria Descartes, MD  more...
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Answer

Delivery history is usually atypical because of abnormal fetal presentation or difficulty due to the fixed fetal joints.

Breech or transverse fetal position is relatively common. Length of gestation is usually normal, but induction of labor is often prolonged. A limb is fractured during traumatic delivery in about 5-10% of cases.

Check for abnormal placenta, membranes, or cord insertion in cases that involve amniotic bands or vascular compromise. The umbilical cord may be shortened or wrapped around a limb, leading to compression.

Arthrogryposis epidemics have been reported, but whether these are due to chance occurrence, environmental factors, or infectious agents is unclear. Any clustering of children born with congenital contractures should be investigated.

In multiple births or twins, lack of movement due to uterine crowding can cause contractures. The death of one twin may lead to vascular compromise in the remaining twin.


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