title: Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2.
abstract: We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.
authors: Department of Obstetrics, Royal Shrewsbury Hospital , Shrewsbury , UK.
authors: Hemant
authors: H
authors: Maraj
authors: Department of Obstetrics, Royal Shrewsbury Hospital , Shrewsbury , UK.
authors: Michelle
authors: M
authors: Mohajer
authors: Department of Medicine, University Hospital of North Staffordshire , Stoke on Trent , UK.
authors: Deepannita
authors: D
authors: Bhattacharjee
keywords: clinical genetics; complications; high-risk pregnancy; rheumatology