Anaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome associated with postural orthostatic tachycardia syndrome

Jones, Tanya; Ng, C.

doi:10.1016/j.ijoa.2008.04.003

Cited by 24 publications

(17 citation statements)

References 28 publications

(37 reference statements)

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“…These controversies are mainly caused by the paucity of studies on consistent numbers of patients with homogenous phenotypes. Anecdotally, normal vaginal delivery can be encouraged in JHS/EDS-HT [Jones and Ng, 2008]. On the other side, aggravation of musculoskeletal and/or systemic symptoms during pregnancy might necessitate Cesarean [Atalla and Page, 1988;Golfier et al, 2001].…”

Section: Delivery Modalities and Complicationsmentioning

confidence: 99%

“…We were not able to collect accurate data about anesthetic procedures in all cases, but our results outline the absence of any major contraindications for total and regional anesthesia in JHS/EDS-HT. Other groups discussed the pros and cons of spinal versus epidural anesthesia in JHS/EDS-HT in relation with hemodynamic changes in case of dysautonomia, local anesthetic resistance for epidural procedures, and risk of hematoma [Jones and Ng, 2008]. The authors proposed a combined spinal-epidural with a moderate spinal dose as the best initial technique with early fluid loading and phenylephrine infusion in presence of dysautonomia.…”

Section: Anesthetic Considerationsmentioning

confidence: 99%

“…Actual knowledge is essentially limited to a handful of case reports [Atalla and Page, 1988;Thornton et al, 1988;Rochelson et al, 1991;Sakala and Harding, 1991;Morales-Rosell o et al, 1997;De Vos et al, 1999;Jones and Ng, 2008;Dutta et al, 2011] and case series mixing various forms of EDS, mainly EDS-HT, EDS classic, and vascular types [Sorokin et al, 1994;McIntosh et al, 1995;Lind and Wallenburg, 2002]. The resulting thought is that pregnancy and delivery appear relatively safe in JHS/EDS-HT.…”

Section: Introductionmentioning

confidence: 99%

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Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients

Castori

Morlino

Dordoni

et al. 2012

American J of Med Genetics Pt A

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Joint hypermobility syndrome (JHS) emerges as likely the most common clinical form of Ehlers-Danlos syndrome. Given the striking predominance of affected women, practitioners often face gynecologic and obstetric issues. However, their decisions are still based on personal experience rather than literature due to the lack of a consistent body of evidence. We collected a set of gynecologic and obstetric features in 82 post-puberal women with JHS attending two Italian centers. Common gynecologic findings were dysmenorrhea (82.9%), meno/metrorrhagias (53.7%), irregular menses (46.3%), and dispareunia/vulvodinia (31.7%). Forty women were nulliparous and 42 had one or more pregnancy for a total of 93 diagnosed conceptions. Of them, 16.1% were spontaneous abortions, 6.5% voluntary interruptions, 10.7% preterm deliveries, and 66.7% deliveries at term. Overall outcome of proceeding pregnancies was good with no stillbirth and fetal/neonatal hypoxic/ischemic event. Non-operative vaginal delivery was registered in 72.2%, forceps/vacuum use in 5.5% and cesarean in 22.3%. Local/total anesthesia was successfully performed in 17 pregnancies without any problem. Major post-partum complications included abnormal scar formation after cesarean or episiotomy (46.1%), hemorrhage (19.4%), pelvic prolapses (15.3%), deep venous thrombosis (4.2%), and coccyx dislocation (1.4%). Prolapses were the most clinically relevant complication and associated with episiotomy. Gathered data were discussed for practically oriented considerations.

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Section: Delivery Modalities and Complicationsmentioning

confidence: 99%

Section: Anesthetic Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients

Castori

Morlino

Dordoni

et al. 2012

American J of Med Genetics Pt A

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“…Jones and Ng [14] suggested that normal vaginal delivery can be encouraged in Joint hypermobility syndrome of Ehlers-Danlossyndromehypermobilitytype (JHS/EDS-HT).…”

Section: Discussionmentioning

confidence: 99%

Joint Hypermobility in Women with Cesarean Section

Al-Rawi¹,

Hasan²,

Gorial³

2014

IOSRJDMS

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“…Cardiovascular complications associated particularly with the vascular subtype of EDS include congenital and valvular heart disease (typically mitral valve prolapse and regurgitation), conduction defects, coronary artery disease and aortic dissection or rupture. Dysautonomia is a recognised complication of the hypermobility subtype [ 122 ]. If required, a stress echocardiogram or thalium scan may be preferred to cardiac catheterisation because of the risk of possible vessel rupture and hemorrhage with the latter.…”

Section: Clinical Features and Complications In The Puerperiummentioning

confidence: 99%

Peri-delivery Analgesia and Anesthesia in Women with Hemostatic or Thrombotic Disorders

Emanuel-Kole

Bell

2015

Disorders of Thrombosis and Hemostasis in Pregnancy

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It is well recognised that labor is painful. Analgesia is therefore required by the vast majority of parturients during labor and delivery. Central neuraxial blockade is the most effective form of analgesia in labor and also the most desirable type of anesthesia for peripartum operative interventions. Inadequate hemostasis is a contraindication to central neuraxial blockade. This chapter will discuss all forms of analgesia available to the laboring woman with a hemostatic or thrombotic disorder, and the implications of abnormalities of hemostasis, with particular emphasis on central neuraxial blockade.

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Anaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome associated with postural orthostatic tachycardia syndrome

Cited by 24 publications

References 28 publications

Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients

Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers–Danlos syndrome hypermobility type) in 82 Italian patients

Joint Hypermobility in Women with Cesarean Section

Peri-delivery Analgesia and Anesthesia in Women with Hemostatic or Thrombotic Disorders

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