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Case Reports in Anesthesiology
Volume 2018, Article ID 1924725, 4 pages
https://doi.org/10.1155/2018/1924725
Case Report

Spinal Anaesthesia for Cesarean Section in a Patient with Vascular Type Ehlers-Danlos Syndrome

1Department of Anesthesiology, United States Naval Hospital Yokosuka, Yokosuka, Japan
2Department of Anesthesiology, Naval Medical Center Portsmouth, Portsmouth, VA, USA

Correspondence should be addressed to Jeffrey M. Carness; lim.liam@lim.ssenrac.m.yerffej

Received 24 October 2017; Accepted 14 December 2017; Published 28 January 2018

Academic Editor: Alparslan Apan

Copyright © 2018 Jeffrey M. Carness and Mark J. Lenart. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report the administration of spinal anaesthesia for cesarean delivery in a parturient with vascular Ehlers-Danlos syndrome. Parturients who genetically inherit this disorder are at risk for significant morbidity and mortality. Risks during pregnancy include premature labor, uterine prolapse, and uterine rupture. Additionally, such laboring parturients are at increased risk of hemodynamic volatility, vascular stress, and severe postpartum hemorrhage. Instrumented delivery and cesarean delivery bring additional risks. Nonpregnancy-related complications include excessive bleeding, intestinal rupture, cardiac valvular dysfunction, and arterial dissection. Despite the complexity of this condition, literature focusing on specific intraoperative anaesthetic management is sparse.