Osteomalacia in pregnant women

One of the main forms osteomalacia is puerperal form, most often occurring in women aged 20-40 years during the second pregnancy (when the first - rare), less frequently after birth and during prolonged lactation. Usually began during pregnancy osteomalacia improved and even cured in the postpartum period.
Causes osteomalacia are specific conditions endemic foci of disease, social conditions (poor living conditions, poor nutrition, a lack of vitamin D, phosphates, lime, exhausting work). In the etiology of puerperal Acting stresses the importance of vitamin D. If the increased need for vitamin D during pregnancy and lactation women's body does not receive it in sufficient quantity, the new bone structure little or no obesesluts.
Puerperal osteomalacia - the disease is chronic and long lasting. When it first and most strongly affects the bones of the pelvis, then an adjacent parts of skeleton - the lower back, upper sections of the thighs and finally, the remaining parts of the skeleton. The bones of the pelvis are deformed, pelvis acquires the characteristic form of the so - called osteomalaciei the pelvis. While Acting develops, the bones are soft and shape their unstable. After recovering, O. deformed bones of the pelvis obesesluts and warp them remains stable. The disease is accompanied by pain in the pelvis and sacrum and other parts of the skeleton (especially when pressed), fatigue, reductions resulting muscles of the hips, difficulty in walking (duck gait). In developing the disease pain worsens; the bones of the pelvis, spine and hips soften and become deformed; the growth decreases patient, paresis, and paralysis. There is a significant loss of lime (increased calcium elimination through the intestines). The disease wavy depending on related conditions and especially in pregnancy. In the course of the disease are observed ongoing enhancements.
The prognosis for puerperal osteomalacia serious. Death rarely occurs from the underlying disease at a picture of gradual exhaustion. Most patients die from opportunistic diseases. In connection with occurrence osteomalation pelvis threatening complications during childbirth. When softened deformation of pelvic bones, in some cases, possible through the natural way, when calcification deformed pelvis delivery is not possible and we have to do cesarean section.
Diagnosis when severe, advanced stages of O., accompanied by deformation of the bones of the pelvis, not difficult due to the characteristic form osteomalation pelvis (the coracoid symphysis, a sharp decrease of the cross-section of the pelvis), pain pelvic bones. At the early stages of lung disease diagnosis is not easy and requires differentiation with rheumatism, neuralgia, asticom etc.
Prevention consists in improvement of social and hygienic conditions of women. It is particularly important balanced diet, rich in vitamins, especially vitamin D, salts, lime, especially phosphates. All these measures should be primarily on pregnant and lactating women.
In the treatment, in addition to adequate food, rich in protein, phosphor, salts of calcium and vitamins, are recommended phosphorus with fish oil. Believing that the cause osteomalacia is insufficient function of the chromaffin system, used adrenaline, pituitrin.
When conservative treatment is shown abortion and termination of breast feeding, castration.