Recognizing Poland syndrome at birth: Chest wall and hand manifestations

DOI: https://doi.org/10.33024/minh.v8i12.1943

Authors

  • Laysa Kasminata Program Studi PPDS Obstetri dan Ginekologi, Universitas Riau
  • Jojor Sihotang Departemen Obstetri dan Ginekologi, Universitas Riau

Newborn Pectoralis Major Agenesis Pectoralis Minor Agenesis Poland Syndrome Syndactyly

Abstract

Background: Poland syndrome is a rare congenital anomaly defined by unilateral agenesis or hypoplasia of the sternocostal head of the pectoralis major, with possible involvement of the pectoralis minor and variable ipsilateral chest wall and upper-limb abnormalities, including syndactyly. The presentation is typically unilateral, more often affecting the right hemithorax, while bilateral involvement is uncommon.

Purpose: To report a neonatal case of Poland syndrome and describe the clinical manifestations and early management to support timely intervention and appropriate care planning.

Method: A case study was conducted at Dumai Hospital involving a preterm neonate delivered to a 27-year-old woman (G2P1A0) at 27 weeks of gestation who presented with uterine contractions and stable vital signs. Prenatal ultrasonography was performed prior to delivery. After birth, the neonate underwent a structured physical examination focusing on the chest wall and upper extremities to identify congenital anomalies, followed by initial stabilization and referral based on clinical findings.

Results: The patient was a female preterm neonate with findings consistent with Poland syndrome, including unilateral absence of the pectoralis major and pectoralis minor on the affected side and ipsilateral hand syndactyly. The infant was referred to the perinatology unit for ongoing monitoring and multidisciplinary management, while the mother received routine postpartum care according to hospital protocol.

Conclusion: Poland syndrome may be recognizable at birth through unilateral thoracic muscle absence with ipsilateral limb anomalies, requiring careful newborn examination and early coordinated care.

Downloads

Download data is not yet available.

References

Agranovich, O. E., Komolkin, I. A., & Dimitrieva, A. J. (2017). Poland’s syndrome. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 5(1), 63–70.

Al-Qattan, M. M. (2001). Classification of hand anomalies in Poland’s syndrome. British Journal of Plastic Surgery, 54(2), 132–136.

Baldelli, I., Baccarani, A., Barone, C., Bedeschi, F., Bianca, S., Calabrese, O., Castori, M., Catena, N., Corain, M., Costanzo, S., De Paoli Barbato, G., De Stefano, S., Divizia, M. T., Feletti, F., Formica, M., Lando, M., Lerone, M., Lorenzetti, F., Martinoli, C., Mellini, L., Nava, M. B., Porcellini, G., Puliti, A., Romanini, M. V., Rondoni, F., Santi, P., Sartini, S., Senes, F., Spada, L., Tarani, L., Valle, M., Venturino, C., Zaottini, F., Torre, M., Crimi, M. (2020). Consensus based recommendations for diagnosis and medical management of Poland syndrome (sequence). Orphanet Journal of Rare Diseases, 15(1), 201.

Bavinck, J. N. B., Weaver, D. D., Opitz, J. M., & Reynolds, J. F. (1986). Subclavian artery supply disruption sequence: Hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies. American Journal of Medical Genetics, 23(4), 903–918.

Bouvet, J. P., Leveque, D., Bernetieres, F., & Gros, J. J. (1978). Vascular origin of Poland syndrome? A comparative rheographic study of the vascularisation of the arms in eight patients. European Journal of Pediatrics, 128(1), 17–26.

Catena, N., Divizia, M. T., Calevo, M. G., Baban, A., Torre, M., Ravazzolo, R., Lerone, M., & Sénès, F. M. (2012). Hand and upper limb anomalies in Poland syndrome: A new proposal of classification. Journal of Pediatric Orthopaedics, 32(7), 722–726.

Chait, F., Bahlouli, N., Chehrastane, R., Mrani Alaoui, N., Boughaleb, F., Zouheir, E. A., Tarik, E. M., Allali, N., El Haddad, S., & Chat, L. (2023). Clinical and radiological features in Poland syndrome: Report of 3 cases and review of literature. Global Pediatric Health, 10, 2333794X231219388.

Chandran, S., Revanna, K. G., Ari, D., & Rana, A. A. (2013). Lung herniation: An uncommon presentation of Poland’s syndrome in a neonate at birth. Case Reports, 2013, bcr2013200106.

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Czeizel, A. E., & Dudas, I. (1992). Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. The New England Journal of Medicine, 327(26), 1832–1835.

Da Silva Freitas, R., Tolazzi, A. R. D., Santos, A. L. R., Graf, R. M., & Cruz, G. A. O. (2008). Poland syndrome. In Breast augmentation: Principles and practice (pp. 345–357).

Di Lorenzo, S., Corradino, B., & Cherubino, M. (2020). Poland’s syndrome. In Plastic and cosmetic surgery of the male breast (pp. 23–29). Springer International Publishing.

Dos Santos Mendo, T., Almeida, T., Maria, A. T., & Tuna, M. L. (2021). Poland syndrome: Neonatal presentation with axillary pterygium. BMJ Case Reports, 14(3), e241395.

Emil, S. (2019). Clinical pediatric surgery: A case-based interactive approach. CRC Press.

Fokin, A. A., & Robicsek, F. (2002). Poland’s syndrome revisited. The Annals of Thoracic Surgery, 74(6), 2218–2225.

Hashim, E. A. A., Quek, B. H., & Chandran, S. (2021). A narrative review of Poland’s syndrome: Theories of its genesis, evolution and its diagnosis and treatment. Translational Pediatrics, 10(4), 1008.

Ibrahim, A., Ramatu, A., & Helen, A. (2013). Poland syndrome: A rare congenital anomaly. Indian Journal of Human Genetics, 19(3), 349.

Jimbo, T., Hori, T., Ushiyama, A., & Masumoto, K. (2022). Congenital partial chest wall defect with extracorporeal intercostal liver herniation. Journal of Pediatric Surgery Case Reports, 86, 102467.

Koc, E., & Unal, S. (2025). Viability of extremely premature neonates: Clinical approaches and outcomes. Journal of Perinatal Medicine, 53(6), 706–715.

Krasovec, K., & Anderson, M. A. (1991). Maternal nutrition and pregnancy outcomes: Anthropometric assessment. Pan American Health Organization.

Lemons, J. A., Bauer, C. R., Oh, W., Korones, S. B., Papile, L. A., Stoll, B. J., Verter, J., Temprosa, M., Wright, L. L., Ehrenkranz, R. A., Fanaroff, A. A., Stark, A., Carlo, W., Tyson, J. E., Donovan, E. F., Shankaran, S., Stevenson, D. K., & NICHD Neonatal Research Network. (2001). Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics, 107(1), e1.

Lin, Z. H. U., Ang, Z. E. N. G., Xiao-jun, W. A. N. G., & Zhi-fei, L. I. U. (2012). Poland’s syndrome in women: 24 cases study and literature review. Chinese Medical Journal, 125(18), 3283–3287.

Orioli, I. M., & Castilla, E. E. (2000). Epidemiological assessment of misoprostol teratogenicity. BJOG: An International Journal of Obstetrics & Gynaecology, 107(4), 519–523.

Patton, M. Q., & Cochran, M. (2002). A guide to using qualitative research methodology. Médecins Sans Frontières, Paris.

Poland, A. (1841). Deficiency of the pectoral muscles. Guy’s Hospital Reports, 6, 191.

Pramanik, A. K., Rangaswamy, N., & Gates, T. (2015). Neonatal respiratory distress: A practical approach to its diagnosis and management. Pediatric Clinics, 62(2), 453–469.

Robb, C. L., Bhalla, S., & Raptis, C. A. (2022). Subclavian artery: Anatomic review and imaging evaluation of abnormalities. Radiographics, 42(7), 2149–2165.

Romanini, M. V., Calevo, M. G., Puliti, A., Vaccari, C., Valle, M., Senes, F., & Torre, M. (2018). Poland syndrome: A proposed classification system and perspectives on diagnosis and treatment. In Seminars in Pediatric Surgery (Vol. 27, No. 3, pp. 189–199). WB Saunders.

Singh, R., & Gupta, K. (2022). Poland Syndrome: Its prevalence and associated implications. Current Overview on Disease and Health Research, 3(3), 9–20.

Tafti, D., & Cecava, N. D. (2023). Poland syndrome. In StatPearls. StatPearls Publishing.

Yin, R. K. (2018). Case study research and applications (Vol. 6). Thousand Oaks, CA: Sage.

Downloads

Published

2026-03-05

How to Cite

Recognizing Poland syndrome at birth: Chest wall and hand manifestations. (2026). MIN, 8(12), 1664-1672. https://doi.org/10.33024/minh.v8i12.1943