A maternal and perinatal mortality in pregnancy complicated by the kyphoscoliotic form of Ehlers-Danlos syndrome

Obstet Gynecol. 2009 Feb;113(2 Pt 2):515-518. doi: 10.1097/AOG.0b013e3181898cbf.

Abstract

Background: Ehlers-Danlos syndrome is a group of inherited connective tissue diseases demonstrating autosomal-dominant, autosomal-recessive, and X-linked inheritance patterns. The diagnosis can be established by clinical, biochemical, and genetic findings.

Case: Our nulliparous patient presented with an unspecified diagnosis of Ehlers-Danlos syndrome. Laboratory testing confirmed the kyphoscoliotic type. Based on clinical and phenotypic similarities with the vascular type of Ehlers-Danlos syndrome, termination was advised. Minor trauma in the third trimester led to delivery of a stillborn fetus, which was followed by disseminated intravascular coagulopathy and death of the mother. Maternal autopsy revealed that there had been a spontaneous rupture of the right iliac artery.

Conclusion: Practitioners should be aggressive in recommending effective birth control in patients with the kyphoscoliotic form of Ehlers-Danlos syndrome. In cases of established pregnancy, patients should be made fully aware of their risks of death and severe complications.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Aneurysm, Ruptured
  • Cesarean Section
  • Disseminated Intravascular Coagulation
  • Ehlers-Danlos Syndrome / complications*
  • Ehlers-Danlos Syndrome / physiopathology
  • Fatal Outcome
  • Female
  • Humans
  • Iliac Artery / pathology
  • Kyphosis / etiology
  • Patient Compliance
  • Pregnancy
  • Pregnancy Complications* / physiopathology
  • Rupture, Spontaneous
  • Scoliosis / etiology
  • Stillbirth