Pregnancy

Offer screening with chorionic villous sampling/amniotic fluid testing

As the mobility may be restricted, a venous thromboembolism risk assessment must take place in the first trimester and a plan for thromboprophylaxis must be made.

The patient should be followed up in a consultant led unit with specialist midwife, occupational health therapist and social worker.

Second trimester anomaly scan

Anaesthetic evaluation, assess risk for malignant hyperthermia, kyphoscoliosis and to plan for pain relief and anaesthetic medications that can be used during labour and delivery.

Aim for vaginal delivery, however positioning during labour must be discussed in a multidisciplinary meeting based on individual situation, considering risk factors like osteopenia and previous surgeries.