Pregnancy-Associated Osteoporosis Presented with Femoral Neck Fracture: A Case Report and Literature Review

Abstract

Background: Pregnancy-associated osteoporosis (PAO) is a rare condition characterized by reduced bone mineral density during the third trimester or lactation. Multiple risk factors, such as genetic, sedentariness, and 25-hydroxy vitamin D deficiency, are associated with PAO. In the majority of cases, PAO is presented with a compression fracture in vertebras, but in our case, it presented with a fracture of the femoral neck. Case Presentation: A 29-year-old, gravida one woman, developed right hip joint pain during the gestational age 34 weeks who referred to our clinic. Despite conservative management, the pain intensified. The patient delivered a healthy neonate in the 38th week of gestation and afterward underwent magnetic resonance imaging of the pelvic, revealing a bruised bone in the femoral neck. Since she had developed a femoral neck fracture during the postpartum period, she underwent open reduction and fixation of the femoral neck. Dual-energy X-ray absorptiometry (DEXA) revealed osteoporosis of the vertebras and femoral neck. She received calcium supplements and alendronate, and the pain was relieved. On 2-year and 4-year follow-up, she was found to be osteopenic with significant improvement in DEXA indices. Conclusion: PAO is a rare condition among young women. This condition should be kept in mind when hip joint or back pain is encountered during pregnancy.