Esaka Emmanuel J, Golde Steven H, Stever Michael R, Thomas Ronald L
From the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Allegheny General Hospital, Pittsburgh, Pennsylvania; and the Department of Obstetrics and Gynecology, Indiana Regional Medical Center, Indiana, Pennsylvania.
Obstet Gynecol. 2009 Feb;113(2 Pt 2):515-518. doi: 10.1097/AOG.0b013e3181898cbf.
Ehlers-Danlos syndrome is a group of inherited connective tissue diseases demonstrating autosomal-dominant, autosomal-recessive, and X-linked inheritance patterns. The diagnosis can be established by clinical, biochemical, and genetic findings.
Our nulliparous patient presented with an unspecified diagnosis of Ehlers-Danlos syndrome. Laboratory testing confirmed the kyphoscoliotic type. Based on clinical and phenotypic similarities with the vascular type of Ehlers-Danlos syndrome, termination was advised. Minor trauma in the third trimester led to delivery of a stillborn fetus, which was followed by disseminated intravascular coagulopathy and death of the mother. Maternal autopsy revealed that there had been a spontaneous rupture of the right iliac artery.
Practitioners should be aggressive in recommending effective birth control in patients with the kyphoscoliotic form of Ehlers-Danlos syndrome. In cases of established pregnancy, patients should be made fully aware of their risks of death and severe complications.
埃勒斯-当洛综合征是一组遗传性结缔组织疾病,呈现常染色体显性、常染色体隐性和X连锁遗传模式。可通过临床、生化和基因检查结果来确诊。
我们的未生育患者被诊断为未明确类型的埃勒斯-当洛综合征。实验室检测确诊为脊柱后侧凸型。基于与血管型埃勒斯-当洛综合征的临床和表型相似性,建议终止妊娠。孕晚期的轻微创伤导致死产胎儿娩出,随后母亲发生弥散性血管内凝血并死亡。母亲尸检显示右髂动脉自发性破裂。
对于脊柱后侧凸型埃勒斯-当洛综合征患者,医生应积极推荐有效的节育措施。对于已怀孕的患者,应让其充分了解死亡和严重并发症的风险。