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

Abstract

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.

• Authors: Marco Castori, Silvia Morlino, Chiara Dordoni, Claudia Celletti, Filippo Camerota, Marco Ritelli, Aldo Morrone, Marina Venturini, Paola Grammatico, Marina Colombi
• Journal: American journal of medical genetics. Part A (Am J Med Genet A) Vol. 158A Issue 9 Pg. 2176-82 (Sep 2012) ISSN: 1552-4833 [Electronic] United States
• PMID: 22847925 (Publication Type: Journal Article, Multicenter Study, Review)
• Copyright: Copyright © 2012 Wiley Periodicals, Inc.

Topics

• Ehlers-Danlos Syndrome (complications, physiopathology)
• Female
• Genitalia, Female (physiopathology)
• Humans
• Italy
• Pregnancy
• Pregnancy Complications (physiopathology)