CONCLUSION
With a wide range of phenotypes in EDS, combined early clinical and
accurate molecular diagnosis can have a profound effect on the
management of pregnant patients with EDS. As molecular diagnosis has
become more widely available, subtyping EDS patients has become more
accessible and the estimated prevalence is growing. One of the issues in
studies investigating outcomes of pregnancy in EDS is the lack of
clearly distinguished subtypes. Relying solely on isolated case reports
does not provide a full picture of the scale of obstetric complications,
with selection and reporting bias being a key issue. Regardless, certain
dominant obstetric features in the classical and hypermobile subtypes
have emerged: prematurity from cervical insufficiency or PROM, pelvic
girdle pain or issues related to the pelvic floor. Perhaps of greater
consequence, vascular EDS predisposes a significant risk of vessel
rupture and perineal tears and may benefit from early caesarean delivery
with specialist anaesthetic input. It is clear that further prospective
research needs to be conducted in individuals with specific subtypes of
EDS. With this in mind, the current review has attempted to highlight
the obstetric complications of each subtype and to suggest potential
management considerations based on clinical features and the limited
evidence base.