A 26-year-old woman recently diagnosed with hypermobile Ehlers-Danlos syndrome (EDS) and pregnant for the first time presents to your office for rheumatologic consultation. Symptoms of low back pain, anterior knee pain, and multiple episodes of subluxation of both hips first presented at age 18. The patient has a history of easy bruising, papyraceous scars, and early-onset striae atrophicae.

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Family history included early-onset hip osteoarthritis in her mother and maternal grandmother. Her father has a history of bilateral hip dislocation. No formal diagnosis of EDS had been established for any of the patient’s family members.

The patient was assessed by a maternal-fetal medicine obstetric specialist following a fetal dating ultrasound at 13 weeks. Following the initial evaluation, she was referred for this rheumatologic consultation, as well as hematology, cardiology, and anesthesiology assessments.

What are some precautions you would advise for this patient with EDS, to minimize potential pregnancy-related complications?

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