Obstetric and gynecologic dysfunction in the Ehlers-Danlos syndrome.
Women members of the newly formed Ehlers-Danlos National Foundation (EDNF) were surveyed with a very detailed questionnaire with 50 questions concerning family history and inheritance, past medical history, and obstetric and gynecologic problems. They entailed the largest extant database on Ehlers-Danlos Syndrome (EDS) patients. The mean age of the 68 women who responded to the survey was 42 years; most had EDS types I, III, IV and unknown. Forty-three women had 138 pregnancies; 13 women never married. The stillbirth rate was 3.15% (3/95); the preterm delivery rate was 23.1% (22/95), and the spontaneous abortion rate was 28.9% (40/138). There was a cesarean delivery rate of 8.4%, with 14.7% having perinatal bleeding problems. One woman (EDS type IV) had congestive heart failure. Common gynecologic problems were recurrent anovulation (41.3%), recurrent vaginal infections (53%), abnormal cytologic smears (19%), sexual dysfunction (61%), irregular menses (28%), endometriosis (15.8%), vaginal dryness (25%) and a need for hysterectomy (19.1%). In this largest series of pregnancies with EDS, we found relatively high rates of abortion, preterm delivery, pregnancy-related bleeding and stillbirth. Women with EDS also seem to have high frequency of anovulation, vaginal infections, abnormal cytologic smears and dyspareunia.
Sorokin
Y
Y
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201.
Johnson
M P
MP
Rogowski
N
N
Richardson
D A
DA
Evans
M I
MI
D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D000858:Anovulation / Q000209:etiology; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology*; D006801:Humans; D007239:Infections / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011795:Surveys and Questionnaires; D014623:Vaginal Diseases / Q000209:etiology