Fetal Diagnostic Institute of the Pacific

We report a case of amniotic band syndrome complicated by constriction bands and marked distal swelling of both lower extremities. Color Doppler interrogation of the right lower extremity revealed complete lack of blood flow below the level of the constriction. Upon fetoscopic survey, the right lower extremity beyond the constriction band appeared dusky red and discolored with desquamation, consistent with a necrotic appearance. The constriction bands were cut in utero using endoshears, thereby allowing restoration of blood flow on postoperative day 1. The patient was counseled extensively regarding the possibility of limb dysfunction or amputation. However, the baby was born with functional lower extremities, and at 21 months of age, the child was cruising and jumping on his own. This case demonstrates that there is unique plasticity in fetal limb recovery after a severe ischemic injury that is not otherwise seen in postnatal life. Reperfusion of the necrotic-appearing limb resulted in restoration of appearance and function without apparent deleterious effects on the fetus. We believe the favorable outcome in this case was likely due to timeliness of the in utero lysis of amniotic bands and the plasticity of fetal healing.

This research has as object of study and research the playfulness in the context of early childhood education.The survey was developed in two rooms of early childhood education: Preschool I and II of a municipal institution, in the city of Presidente Prudente, and was attended by fifty-five children and two teachers.The investigation arose from the observation that some educators are unaware of or ignore the importance of childhood Cultures, mainly the axis playfulness.The theoretical framework of this research is the sociology of Childhood.The methodology used is qualitative in nature and is characterized as ethnographic type lookup.The collected results reveal that the educators understand the importance of play in the classroom.However, is prevalent, the devaluation of the playfulness and imagination of students, some educators and an excessive zeal for the field of reading and writing, this educational modality.