Exp Clin Endocrinol Diabetes 2007; 115(2): 139-142
DOI: 10.1055/s-2007-967091
Case Report
© J. A. Barth Verlag in Georg Thieme Verlag KG · Stuttgart · New York

The Use of i. v. Bisphosphonate in Pregnancy-Associated Osteoporosis - Case Study

L. Hellmeyer 1 , M. Kühnert 1 , V. Ziller 2 , S. Schmidt 1 , P. Hadji 2
  • 1Department of Obstetrics and Perinatal Medicine, Philipps-University of Marburg, Marburg, Germany
  • 2Department of Endocrinology, Osteoporosis and Reproductive Medicine, Clinic for Gynecology and Oncology, Philipps-University of Marburg, Marburg, Germany
Weitere Informationen

Publikationsverlauf

received 20. 12. 2005 first decision 29. 05. 2006

accepted 2. 06. 2006

Publikationsdatum:
22. Februar 2007 (online)

Abstract

Objective: Diagnosis of pregnancy-associated osteoporosis is often delayed and therapeutic interventions insufficient.

Study design: A 28-year-old patient (BMI=18.6) with no additional risks for osteoporosis experienced acute lumbosacral pain two months postpartum, while lactating. After conservative therapy, thoracic and lumbar spine were X-rayed: severe pregnancy-associated osteoporosis with vertebral fractures was diagnosed. 2-year treatment with i. v. bisphosphonate ibandronate was initiated (2 mg every 3 months) and calcium and vitamin D supplementation.

Results: Rapid improvement was observed. Conclusion: In cases with multiple fractures i. v. bisphosphonate leads to substantial decrease of symptoms and further fractures and significant increase of bone mass density (BMD).

Conclusion: In severe cases of pregnancy-associated osteoporosis with multiple fractures i. v. biphosphonate therapy leads to a decrease of symptoms and fracture risk and an increase of bone mass density (BMD).

References

  • 1 Bartl R. Osteoporose.  Internist. 2002;  43 1529-1543
  • 2 Dunne F, Walters B, Marshall T, Heath DA. Pregnancy associated osteoporosis.  Clin Endocrinol. 1993;  39 487-490
  • 3 Eisman J. Relevance of pregnancy and lactation to osteoporosis? Commentary.  Lancet. 1998;  352 504-505
  • 4 Gallacher SJ, Fraser WD, Owens OJ. et al . Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy.  Eur J Endocrinol. 1994;  131 369-374
  • 5 Hadji P, Bock K, Emons G, Wüster C, Schulz KD. Früherkennung und Prävention der Osteoporose.  Gynäkologe. 2002a;  35 518-526
  • 6 Hadji P, Bock K, Wüster C, Emons G, Gottschalk M, Schulz KD. Osteodensitometrie: Quo vadis?.  Reproduktionsmedizin. 2001;  17 261-270
  • 7 Hadji P, Ziller V, Kalder M. et al . Influence of pregnancy and breastfeeding on quantitative ultrasonometry of bone in postmenopausal women.  Climacteric. 2002b;  5 277-285
  • 8 Haram K, Thodarson H, Hervig T. Calcium homeostasis in pregnancy and lactation.  Acta Obstet Gynaecol Scand. 1993;  72 509-513
  • 9 Hellmeyer l, Hadji P, Ziller V, Wagner U, Schmidt S. Osteoporose in der Schwangerschaft.  Geburtsh Frauenheilk. 2004;  64 38-45
  • 10 Levav AL, Chan l, Wapner RJ. Long-term magnesium sulfate tocolysis and maternal osteoporosis in a triplet pregnancy: A case report.  Am J Perinatol. 1998;  15 43-46
  • 11 Munns CFJ, Rauch F, Ward L, Glorieux FH. Maternal and fetal outcome after long-term pamidronate treatment before conception: A report of two cases.  JBMR. 2004;  19 1742-1745
  • 12 Phillips AJ, Ostlere SJ, Smith R. Pregnancy-associated osteoporosis: does the skeleton recover?.  Osteoporos Int. 2000;  11 449-454
  • 13 Saraux A, Bourgeais F, Erhart A, Baron D, Le Goff P. Ostéoporose de lagrossesse: quatre obversations.  Rev Rhum Ed Fr. 1993;  60 596-600
  • 14 Smith R, Athanasou NA, Ostlere SJ, Vipond SE. Pregnancy-associated osteoporosis.  Q J Med. 1995;  88 865-878

Correspondence

L. Hellmeyer

Department of Obstetrics and Perinatal Medicine

Philipps-University of Marburg

Pilgrimstein 3

35037 Marburg

Germany

Telefon: +49/642/12 86 44 04

Fax: +49/642/12 86 45 43

eMail: hellmeye@med.uni-marburg.de