Osteomalacia is caused by pregnancy and lactation when woman’s store of calcium are greatly reduced by inadequate diet, repeated pregnancies and prolonged lactation during previous pregnancies or sprue and steatorrhoea. This is a calcium deficiency disease either caused by inadequate intake of calcium or vitamin D (this is necessary for absorption of calcium from intestine) in diet or excess of calcium loss through milk in prolonged lactation or spure and steatorrhoea. The disease can be encountered in different parts of the world particularly in Indian subcontinent where women live in purdah (cloth that covers the body) effecting lack of vitamin D. There is decalcification of bones; as a result there is bowing spine forward and also that of legs; the pelvis assumes trifoliate due to collapse of side walls and sacrum. There are aching pains and tenderness in bones, waddling gait. Radiology shows in an advanced case radiotransparency of bones and skeletal deformity particularly that in pelvis. The disease gets worse with increasing number of pregnancies and lactation and also in advanced pregnancy. There may be increased foetal movements. First or even second baby is delivered normally but subsequently obstructed labor can develop due to osteomalacic pelvis. Baby is born usually healthy but in severe cases may be born with rickets.
Treatment: Adequate calcium and vitamin D are provided daily as mild 1-2 pints, tablet ostocalcium t.d.s. and vitamin D 600,00 i.u. (inj.ostelin forte) i.m. twice weekly. For osteomalaicic pelvis, close antenatal care is important and caesarean section is the method of delivery for severe pelvic contraction.
0 comments:
Post a Comment