OSTEOPOROSIS DURING PREGNANCY AND ITS MANAGEMENT

Osteoporosis leading to fracture can occur during pregnancy. Bone dens ity may be low before pregnancy due to recognised causes such as coeli ac disease, osteogenesis imperfecta and previous anorexia nervosa (sec ondary osteoporosis). In some patients there is no identifiable cause. This condition is referred to as ''pregnancy associated or pregnancy related osteoporosis''; it is not known whether pregnancy causes the o steoporosis or merely coincides with it. Typically the loss of bone le ads to vertebral fracture with loss of height or pain in the hips also sometimes with fracture. Symptoms most often begin in the third trime ster of the first pregnancy and improve after delivery; they do not us ually recur in subsequent pregnancies. The cause is unknown and there is no specific treatment; follow up bone density measurements show tha t the osteoporosis slowly improves post partum. Recent research in non osteoporotic women shows that breast feeding maintains a low bone den sity; it is therefore contraindicated in pregnancy associated osteopor osis.