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Master Thesis

Syndrome d’Ehlers-Danlos vasculaire : complications et prise en charge anesthésique au cours de la grossesse et du péri-partum

Abstract : Introduction: vEDS is an inheritable connective tissue disorder responsible for high morbidity and mortality, especially during pregnancy, due to vascular, digestive, uterine and respiratory complications. Few data are available regarding general and epidural or spinal anesthesia complications, making medical care difficult. This study presents the analysis of anesthetic management and specific complications of vEDS during pregnancy.
Methods: An observational retrospective study (1990-2012) on medical management of vEDS patient’s pregnancies followed at hospital Européen Georges Pompidou.
Results: We described 29 patients and 40 pregnancies. Maternal mortality was 3.4% at 40 days and 6.9% at one year. Severe complications occurred during vaginal delivery: perineal lesions (38.1%), vascular complications (10.3%) including one death. Cesarean sections complications were post-partum hemorrhage (38.8%) and visceral rupture (6.9%). We reported no complication involving general or spinal and epidural anesthesia. The insertion of a peripheral catheter was frequently difficult (73.3%). Use of opiates at the time of anesthetic induction decreased hemodynamic variations during surgery.
Conclusion: vEDS pregnant patients need multidisciplinary management. Elective cesarean section seems to be the best approach. Whereas spinal or epidural anesthesia might be discussed in some cases, general anesthesia is a reasonable choice for hemorrhage risk management.
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Master Thesis
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  • HAL Id : dumas-01168886, version 1

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Anne Rosa. Syndrome d’Ehlers-Danlos vasculaire : complications et prise en charge anesthésique au cours de la grossesse et du péri-partum. Médecine humaine et pathologie. 2014. ⟨dumas-01168886⟩

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