title: [Osteoporosis and multiple pregnancy--a case report with positive outcome].
abstract: BACKGROUND
  Pregnancy-associated osteoporosis is a rare condition. Due to the rareness of pregnancy-associated osteoporosis, no guidelines concerning an adequate therapy exist. However, since many antiresorptive drugs are potentially teratogenous, the therapeutic approach is limited.
  
  
  METHODS
  In a 30-year-old patient, pubic fracture occurred during her first pregnancy. Osteodensitometry revealed a distinct osteoporosis. The bone density improved under therapy with sex hormones, alendronate, 1,000 mg calcium and 1,000 IU cholecalciferol daily, but still remained osteoporotic when the patient again became pregnant 3 years later. During her triplet pregnancy the patient was treated with 3,000 mg calcium and 1,500 IU cholecalciferol daily. After delivery the bone density remained at the same level as immediately before the second pregnancy.
  
  
  CONCLUSIONS
  Regarding the nonoccurrence of the expected considerable bone loss with this treatment the efficacy of this therapeutic approach during pregnancy warrants further study.
authors.affiliation: Medizinische Klinik I mit Poliklinik der Friedrich-Alexander-Universität Erlangen-Nürnberg. igor.harsch@med1.imed.uni-erlangen.de
authors.forename: I A
authors.initials: IA
authors.lastname: Harsch
authors.forename: R H
authors.initials: RH
authors.lastname: Hübner
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: J
authors.initials: J
authors.lastname: Hensen
mesh_terms: D000328:Adult; D019386:Alendronate; D015519:Bone Density / Q000187:drug effects; D002120:Calcium Channel Agonists / Q000627:therapeutic use*; D002136:Calcium, Dietary / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000627:therapeutic use*; D000075202:Contraindications; D004359:Drug Therapy, Combination; D005260:Female; D005598:Fractures, Spontaneous / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000188:drug therapy* / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011630:Pubic Bone / Q000000981:diagnostic imaging / Q000293:injuries; D011859:Radiography; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D002120:Calcium Channel Agonists; D002136:Calcium, Dietary; D002762:Cholecalciferol; D019386:Alendronate