Are there any special orthopaedic concerns during pregnancy for women with the Marfan syndrome?
Joint laxity tends to increase as a pregnancy progresses. As a result, many women with the Marfan syndrome who have joint problems prior to pregnancy experience a worsening of these symptoms during pregnancy. This increase in discomfort frequently includes pain in the lower back, pelvis and legs that is exacerbated with walking and improves when sitting or reclining. Occasionally, the pelvic pain persists despite sitting or joint discomfort becomes too great, thus requiring bed rest for varying portions of the pregnancy. Labor and Delivery Is a vaginal or cesarean birth safer for a woman with the Marfan syndrome? The several large studies describing the outcomes of pregnancies for women with the Marfan syndrome suggest that for women with aortic diameters less than 4.0 cm at the time of delivery are similar for vaginal and cesarean section delivery. Recommendations for management of labor include: • Epidural analgesia for the labor and delivery process to maintain stable blood pressure
