Pregnancy-associated osteoporosis and multiple pregnancy - A course with positive outcome

Background: Pregnancy-associated osteoporosis is a rare condition. Due to t he rareness of pregnancy-associated osteoporosis, no guidelines concerning an adequate therapy exist. However, since many antiresorptive drugs are pot entially teratogenous, the therapeutic approach is limited. Case Report: In a 30-year-old patient, pubic fracture occurred during her f irst pregnancy. Osteodensitometry revealed a distinct osteoporosis. The bon e density improved under therapy with sex hormones, alendronate, 1,000 mgca lcium and 1,000 IU cholecalciferol daily, but still remained osteoporotic w hen the patient again became pregnant 3 years later. During her triplet pre gnancy the patient was treated with 3,000 mg calcium and 1,500 TU cholecalc iferol daily. After delivery the bone density remained at the same level as immediately before the second pregnancy. Conclusion: Regarding the nonoccurrence of the expected considerable bone l oss with this treatment the efficacy of this therapeutic approach during pr egnancy warrants further study.