Transient osteoporosis of the hip in pregnancy associated with generalized low bone mineral density--a case report.

Transient osteoporosis of the hip (TOH) in pregnancy is characterized by severe pain in unilateral or bilateral hips and has been diagnosed as localized osteopenia. However, we evaluated a case of unilateral TOH with generalized profound osteoporosis involving both the hips and the lumbar vertebrae by dual-energy X-ray absorptiometry. The diagnosis was based on the clinical course and confirmed by magnetic resonance imaging. Three-dimensional helical computed tomography (3D-CT), which has not been used in patients with TOH, revealed a markedly thin bilateral proximal femoral cortex, particularly in the symptomatic femoral head. Despite the difference in the severity of bone destruction between the two femora, they both showed the same pattern of damage on 3D-CT. Furthermore, despite continuing treatment with the same dose of alendronate and calcitriol, a high rate of bone mineral density gain, involving both the femora and lumbar vertebrae, was limited to the early postpartum months. A majority of reported female patients with TOH are pregnant. Thus, the association between TOH and pregnancy was not considered to be fortuitous, and chemical or hormonal factors related to pregnancy may play an etiologic role in this disease. The possible etiologies of TOH in pregnancy are also discussed.

Relation of prenatal and postnatal status to calcaneus quantitative ultrasound in adolescents.

This study aimed to elucidate the relationship of prenatal and/or postnatal factors, including acquired factors, with the calcaneus stiffness index as measured by quantitative ultrasound (QUS-SI) in adolescents. We recruited 1,143 adolescents with a mean age of 14.8 ± 1.8 years (501 boys and 642 girls). The subjects' calcaneus QUS-SI was measured using an ultrasound bone densitometer. We also measured the subjects' height, weight, and grip strength. Data on prenatal and postnatal factors were obtained from maternal and child health handbooks. A self-reporting questionnaire was used to obtain information on subjects' secondary sexual characteristics and lifestyle factors. We found that maternal weight gain during pregnancy was independently associated with calcaneus QUS-SI in girls, and that grip strength was also significantly associated with calcaneus QUS-SI in both sexes. The present findings suggest that excessive restriction of maternal weight gain would have a negative effect on the calcaneus QUS-SI of girls, and that exercise and strength-building activities are likely to result in a higher calcaneus QUS-SI in both sexes of adolescents.

Maternal weight gain rate in the second trimester are associated with birth weight and length of gestation.

BACKGROUND: Low total weight gain during pregnancy has been widely accepted as a valid risk factor for small-for-gestational-age infants and pre-term births. However, it is not obvious in which trimester the weight gain rate most affects birth weight and length of gestation. METHOD: Using logistic regression analysis and Pearson's correlation coefficient test, data from 472 women who had vaginally delivered an infant at term without any complications were analyzed retrospectively. RESULTS: Pre-pregnancy underweight and low total maternal weight gain were significant independent predictors of small-for-gestational-age infants and shortened gestations. Pre-pregnancy weight was significantly related to the birth weight and length of gestation (r = 0.18, p < 0.0001; r = 0.10, p = 0.04, respectively), and total weight gain was also significantly related to those (r = 0.17, p = 0.0003; r = 0.11, p = 0.03, respectively). Significant correlations between maternal weight gain rate in the second trimester and the birth weight and length of gestation were found (r = 0.32, p = 0.005; r = 0.40, p = 0.0003, respectively), while such correlations were not found in the first or third trimester. CONCLUSION: The most sensitive period of maternal weight gain for the birth weight and length of gestation was the second trimester.

Pregnancy complicated with lactate dehydrogenase M-subunit deficiency: the first case report.

A woman with lactate dehydrogenase M-subunit deficiency underwent two cesarean sections because of the risk of dystocia due to decreased adenosine triphosphate production in anaerobic glycolysis including uterine muscles. Frequent pains with increased serum pyruvate levels were observed during the third trimester of her pregnancies.