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Frank N. H. Harrison, Jr., MD
Department OB/GYN
Carolinas Medical Center
Charlotte, NC
Ehlers Danlos Syndrome
(EDS)
 A rare connective tissue disorder
characterized by tissue fragility,
translucent skin and joint
hypermobility
EDS
 Yucky collagen
EDS Types
 Type I (gravis)




severe
Type II (mitis)
mild
Type III (hypermobile)
joints
Type IV (vascular)
acrogenic facies
Type V (x-linked)
moderate
EDS Types
 Type VI (ocular scoliotis)
 Type VII (arthrochalasis
 Type VIII (peridontitis)
 Type IX (fibronectin)
scoliosis,
detached retina
micronathia
tooth loss
stria
Collagen
 A fibrous protein found in connective tissue
 Includes 19 proteins encoded by 35
nonallelic genes scattered over 15
chromosomes
 TNXB gene  tenasion-X  Type III
 Provides structure, strength & flexibility to
tissue
EDS & Women’s Health
I
Preadolescent
(<12-15y)
 II Reproductive age group (15-40y)
 III Peri and post menopause(>40y)
Preadolescent
 Diagnosis can be difficult
 Age of symptoms – 6yo
 Age of diagnosis – 9yo
Diagnosis
Major Criteria
 Translucent skin
 Arterial, intestinal, uterine rupture
 Bruising
 Acrogenic facies
Diagnosis
Minor Criteria
 Tendon or muscle rupture
 Clubbed feet
 Early varicose veins
 Early pneumothorax
 Gingival recession
 + family history
Preadolescent
Diagnosis
 Procollagen III deficiency
 Stain biopsy – COL3AI mutation
Preadolescent
 Contact sports
 Accident avoidance
 Joint bracing
 Contraception
 Injury handling
Reproductive Age
 Contraception
 50% vertical transmission
 Endometriosis
 Pregnancy planning
 Poor wound healing
Pregnancy & EDS
 Type IV advise against
 Close multidisciplinary f/u
 30 weeks antenatal steroids
 Early delivery ?1o c/s
Perimenopause Postmenopause
 Pelvic organ prolapse
 Stress urinary incontinence
 Dyspareunia
 Mesh vs. no mesh