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Anesthetic Management of a Pregnant Patient With Ehlers-Danlos Syndrome Undergoing Elective Cesarean Delivery: A Case

Yahya M Aljuba1, Daniel Shatalin2, Alexander Ronenson1

  • 1Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center (Affiliated with the Hebrew University of Jerusalem), Jerusalem, ISR.

Cureus
|September 8, 2025
PubMed

Pregnancy in women with Ehlers-Danlos syndrome (EDS) carries elevated risks, including prematurity, hemorrhage, and maternal morbidity, posing significant anesthetic challenges. We present the case of a 36-year-old woman with classical EDS (cEDS) and multiple comorbidities, including postural orthostatic tachycardia syndrome, bronchial asthma, congenital adrenal hypoplasia, and chronic venous thrombosis, who underwent an elective cesarean section. A multidisciplinary team developed a comprehensive perioperative plan featuring ultrasound-guided spinal anesthesia, extended post-anesthesia observation, and coordinated recommendations from cardiology, hematology, endocrinology, pulmonology, and other specialties. This report emphasizes the complexity of anesthetic care in EDS pregnancies and underscores the need to tailor management to the specific EDS subtype and individual patient profile.

Keywords:
cesarean section (cs)ehlers-danlos syndromemultidisciplinary approachneuraxial anesthesiaobstetric anesthesia

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