Pregnancy-associated osteoporosis: an underestimated and underdiagnosed severe disease. A review of two cases in short- and long-term follow-up.

Pregnancy-associated osteoporosis is an uncommon condition characterized by the occurrence of painful fractures during late pregnancy or lactation. To date the pathophysiology of this entity of bone disorder is still uncertain, and its therapeutical management is poorly defined. We report two clinical cases: a 10-years follow-up with pain medication and intermittent antiresorptive therapy courses, subsequent traumatic vertebral fracture and actually fracture of scaphoid after inadequate trauma. Beside this long-term course a young female patient with pregnancy-associated osteoporosis and painful lumbar and also thoracic vertebral fractures is described. She was treated with an osteoanabolic therapy, at the timepoint of first follow-up at 6 months of treatment a solid increase of bone mineral density and sustained pain reduction was observed.