Complications
The musculoskeletal manifestations of hypermobile EDS have been found to have a marked effect on patient physical activity and quality of life.[21]
Can occur, especially if steps are not taken to reduce joint instability.
Wound suturing may be problematic due to tissue friability. Bleeding risk should always be considered before performing a surgical procedure in these patients, particularly in those with vascular EDS.
Surgical procedures may be further complicated by lack of or reduced response to local anaesthetic agents.[18][49]
Unlike vascular EDS, hypermobile EDS is not associated with heart disease or major hazards (e.g., bowel rupture) during pregnancy and labour.[50] However, the following can occur:[51] 1) joint and spinal pains may increase during the course of the pregnancy, 2) membranes can rupture prematurely, with consequent premature labour and delivery; labour may be rapid, 3) the apparent resistance to the effects of local anaesthetics can cause problems during epidural anaesthesia or infiltration for repair of a tear or episiotomy, 4) healing of tear or episiotomy may be impaired and/or prolonged, and surgical technique may need to be modified accordingly, 5) lactation and care of the newborn baby may be more taxing than for mothers who do not have EDS, 6) pelvic floor problems (e.g., uterine prolapse) may occur in later life, so postnatal pelvic floor exercise is particularly important.
Large or medium-sized arteries, intestines, uterus, and/or tendons can spontaneously rupture or tear, primarily in vascular EDS. Sudden death may occur. Surgery and invasive radiology are therefore best avoided as far as possible in these patients.
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