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However, their decisions are still based on personal experience rather than literature due to the lack of a consistent body of evidence. We collected a set of gynecologic and obstetric features in 82 post\u2010puberal women with JHS attending two Italian centers. Common gynecologic findings were dysmenorrhea (82.9%), meno\/metrorrhagias (53.7%), irregular menses (46.3%), and dispareunia\/vulvodinia (31.7%). Forty women were nulliparous and 42 had one or more pregnancy for a total of 93 diagnosed conceptions. Of them, 16.1% were spontaneous abortions, 6.5% voluntary interruptions, 10.7% preterm deliveries, and 66.7% deliveries at term. Overall outcome of proceeding pregnancies was good with no stillbirth and fetal\/neonatal hypoxic\/ischemic event. Non\u2010operative vaginal delivery was registered in 72.2%, forceps\/vacuum use in 5.5% and cesarean in 22.3%. Local\/total anesthesia was successfully performed in 17 pregnancies without any problem. Major post\u2010partum complications included abnormal scar formation after cesarean or episiotomy (46.1%), hemorrhage (19.4%), pelvic prolapses (15.3%), deep venous thrombosis (4.2%), and coccyx dislocation (1.4%). Prolapses were the most clinically relevant complication and associated with episiotomy. Gathered data were discussed for practically oriented considerations. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajmg.a.35506","type":"journal-article","created":{"date-parts":[[2012,7,28]],"date-time":"2012-07-28T05:12:45Z","timestamp":1343452365000},"page":"2176-2182","source":"Crossref","is-referenced-by-count":92,"title":["Gynecologic and obstetric implications of the joint hypermobility syndrome (a.k.a. Ehlers\u2013Danlos syndrome hypermobility type) in 82 Italian patients"],"prefix":"10.1002","volume":"158A","author":[{"given":"Marco","family":"Castori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Morlino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Dordoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Celletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Camerota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ritelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Morrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Venturini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Grammatico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Colombi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,27]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"508","article-title":"Ehlers\u2010Danlos syndrome type III in pregnancy","volume":"71","author":"Atalla A","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.32.5.413"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-011-2275-2"},{"key":"e_1_2_7_6_1","first-page":"998","article-title":"Symptom and joint mobility progression in the joint hypermobility syndrome (Ehlers\u2010Danlos syndrome, hypermobility type)","volume":"29","author":"Castori M","year":"2011","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.2012.01858.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000020930"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d1002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/306413"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0004.2001.600312.x"},{"key":"e_1_2_7_12_1","first-page":"1777","article-title":"The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS)","volume":"27","author":"Grahame R","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_7_13_1","first-page":"245","volume-title":"Hypermobility, fibromyalgia and chronic pain","author":"Grahame R","year":"2010"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2003.08.001"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2006.07.013"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318240df4f"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182267f2f"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2008.04.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-004-0671-5"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.810403.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2011.187"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/107155769500200309"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004040050196"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d1003"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00492.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker140"},{"key":"e_1_2_7_27_1","first-page":"268","article-title":"The use of prophylactic desmopressin (DDAVP) in labor to prevent hemorrhage in a patient with Ehlers\u2010Danlos syndrome","volume":"91","author":"Rochelson B","year":"1991","journal-title":"N Y State J Med"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(97)00007-9"},{"key":"e_1_2_7_29_1","first-page":"622","article-title":"Ehlers\u2010Danlos syndrome type III and pregnancy. 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