How Will Ehler Danlos Affect Childbirth?

Most patients with Ehler Danlos syndrome have an unremarkable pregnancy with few complications. The most common complaint during pregnancy for Ehler Danlos syndrome patients is joint pain and dislocation. Patients can also suffer from increased bruising and edema due to skin sensitivity. Childbirth, however, is the one time during pregnancy when all Ehler Danlos patients are at increased risk due to problems with connective tissue.

Ehler Danlos and Vaginal Childbirth

During a vaginal childbirth, hyperflexible connective tissue may seem like a positive trait as the baby should travel through the birth canal with relatively little trouble. Ehler Danlos syndrome patients do not face problems with vaginal childbirth, in most cases, unless an episiotomy is required or vaginal tissues tear. Wounds tend to spread wider in patients with Ehler Danlos syndrome due to skin elasticity. When closing wounds, sutures need to be carefully placed and pulled just tight enough to hold the wound closed. Pulling sutures too tight can cause wound dehiscence or a reopening of the wound as skin tears. Alternatives to closing the wound with sutures include medical grades glues and tape.

Ehler Danlos and Cesarean Birth

Women with Ehler Danlos can undergo cesarean delivery (C-section) if medically necessary. The attending obstetrician needs to be familiar with the symptoms and characteristics of the patient's Ehler Danlos type before attempting a C-section delivery. More severe cases of Ehler Danlos can make closing the uterus and skin difficult. The fragility of maternal skin is often increased due to swelling and weight gain making it even harder to close wounds.

Potential Risks During Childbirth for Ehler Danlos Patients

It is just as important for pregnant women with Ehler Danlos syndrome to understand the potential risks during childbirth as it is for the attending obstetrician. Here is a short list of the risks pregnant women face during childbirth when Ehler Danlos is present.

Vaginal Childbirth - Early abruption of membranes, premature delivery, tearing of the vagina, gaping of vaginal tears and difficulty closing vaginal tears.

C-Section Childbirth - Difficulty closing surgical incisions, increased time spent under anesthesia while wounds are sutured, tearing of skin around sutures, tearing of skin around surgical glue, increased bruising and abnormal formation of scar tissue.

A geneticist can help determine the type of Ehler Danlos syndrome a pregnant woman is suffering from if the condition has not been typed. At least one form of Ehler Danlos syndrome affects blood vessels and organs which could cause even more complications during childbirth.