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Pregnancy and post-pregnancy avascular necrosis of the femoral head

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Summary

Nine cases in the literature and seven patients in our series with hipache due to avascular necrosis of the femoral head have been reviewed. The onset of symptoms is related to pregnancy.

The high adenocortical activity during pregnancy is invoked as a possible explanation of pregnancy avascular necrosis of the femoral head. Maternal parathyroid gland hyperplasia and the elevated parathyroid hormone during pregnancy may play an additional adverse effect on bones. Mechanical stress, due to a difficult labour or excessive weight gain during the last trimester of pregnancy, may be another aetiological factor.

Zusammenfassung

Neun Fälle der Literatur und sieben Fälle des eigenen Krankengutes mit Hüftschmerzen bei ischämischen Hüftkopfnekrosen wurden analysiert. Der Beschwerdebeginn steht in Beziehung zu einer Schwangerschaft.

Die hohe adrenocorticale Aktivität während der Schwangerschaft wird als eine mögliche Ursache für die schwangerschaftsbedingte avaskuläre Hüftkopfnekrose herausgestellt. Die Hyperplasie der mütterlichen Nebenschilddrüsen and der erhöhte Spiegel des Nebenschilddrüsen-Hormons während der Schwangerschaft können einen weiteren ungünstigen Einfluß auf die Knochen haben. Mechanische Beanspruchung als Folge schwerer Arbeit oder einer starken Gewichtszunahme während der letzten 3 Schwangerschaftsmonate kann ein weiterer ätiologischer Faktor sein.

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Cheng, N., Burssens, A. & Mulier, J.C. Pregnancy and post-pregnancy avascular necrosis of the femoral head. Arch. Orth. Traum. Surg. 100, 199–210 (1982). https://doi.org/10.1007/BF00442735

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