Authors: Nada VujasinovicStupar Nada Pejnovic Ljiljana Markovic Maja Zlatanovic
Publish Date: 2011/02/16
Volume: 32, Issue: 3, Pages: 819-823
Abstract
Pregnancyassociated spinal osteoporosis PPSO is a rare condition characterized by severe back pain occurring near the end of the first pregnancy or shortly afterward The aim of this report is to present a 12year followup of a patient with PPSO Also the outcomes of patient’s two pregnancies and her infants after longterm treatment with bisphosphonates are assessed A young woman was referred to our tertiary care hospital aged 30 years due to intense pain in thoracic and lumbar region that started during the last month of her first pregnancy and got worse after delivery Bone mineral density BMD measurement clinical and biochemical parameters were performed Extremely low lumbar spine BMD L2–L4 0627 g/cm2 Tscore −48 Zscore −43 52 young adult indicated severe osteoporosis Cyclical treatment with etidronate and then pamidronate was started and a substantial increase in the BMD and the reduction in back pain intensity were observed An increase in BMD of 448 over baseline was observed after 12 years of followup Her two pregnancies were uneventful and no neonatal adverse effects were observed Control DXA scan in her girl child aged 68 years revealed low BMD at the lumbar spine As PPSO seems to be an underdiagnosed severe disease caution is recommended if back pain occurs in the last trimester or early postpartum period Although prepregnancy use of bisphosponates does not pose a substantial fetal risk their use in women of childbearing age might best be done only when strong clinical indications exist
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