Ehlers-Danlos Anaesthesia — FRCA Final MCQ

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HardObstetric AnaesthesiaEhlers-Danlos AnaesthesiaFRCA Final

A 30-year-old woman (ASA I) with Ehlers-Danlos syndrome (hypermobile type) requires emergency caesarean section. What is the most important anaesthetic consideration?

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Correct answer: E — Tissue fragility – risk of arterial line complications, difficult vascular access, and excessive bleeding

Ehlers-Danlos syndrome (EDS) affects collagen synthesis, causing tissue fragility, joint hypermobility, and vascular fragility. Anaesthetic considerations include: tissue fragility (difficult IV access, risk of haematoma from arterial lines, fragile skin requiring careful tape placement), potential cervical spine instability (careful airway management), TMJ laxity (may actually make intubation easier), and in vascular EDS (type IV): risk of arterial dissection/rupture and uterine rupture. Regional anaesthesia is NOT contraindicated but epidural haematoma risk may be slightly increased due to vascular fragility.

Reference: RCOA – 2023 – Connective tissue disorders; Wiesmann T – 2014 – EDS and anaesthesia