FURTHER EVIDENCE THAT ARTHROGRYPOSIS MULTIPLEX CONGENITA IN THE HUMAN SOMETIMES IS CAUSED BY AN INTRAUTERINE VASCULAR ACCIDENT

A 7-1/2-year-old girl with arthrogryposis multiplex congenita of the amyoplasia type in association with intestinal atresias, gastroschisis, Mobius anomaly, and hypoplasia of the pectoral, biceps, and deltoid muscles is described. Several combinations of these birth defects have been previously described. There is considerable evidence that gastroschisis, intestinal atresia, Poland sequence, and Mobius anomaly each has a vascular pathogenesis. Based on the associations seen in this child and past reports of more limited, similar cooccurrences, we suggest that arthrogryposis multiplex congenita may sometimes be caused by an intrauterine vascular catastrophe.