Anaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome type IV

We report the successful use of combined spinal and extradural anaesthesia for elective Caesarean section in a primigravid patient with Ehlers-Danlos type IV (EDS IV). EDS IV is a rare disorder with a high pregnancy-related mortality. Previous reports have not addressed the question of anaesthesia for delivery. It is not possible to be didactic about anaesthetic technique for such patients. The relative risks of general and regional anaesthesia must be discussed fully, and the risks weighed against the wishes of the woman and her partner.