SUCCESSFUL PREGNACY OUTCOME IN A CASE OF OSTEOGENESIS IMPERFECTA WITH HIPOPITUITARISMUS

Ruhide Azemi Neziri; Slagjana Simeonova Krstevska; Biljana Todorova; Aleksandar Bojadziev

Ruhide Azemi Neziri Resident at University Clinic for gynecology and obstetrics, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North macedonia
Slagjana Simeonova Krstevska University Clinic for Gynecology and Obstetrics , Faculty of Medicine Ss Cyril and Methodius University in Skopje, North Macedonia
Biljana Todorova University Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Skopje, North Macedonia
Aleksandar Bojadziev Private Clinical Hospital Acibadem- Sistina, Skopje, North Macedonia

Abstract

Case report

Osteogenesis imperfecta (OI), first described in the seventeenth century, is a rare inherited connective tissue disease, characterized by bone fragility, low bone mass, and susceptibility to bone fractures with variable severity. Osteogenesis imperfecta (OI) or brittle bone disease is a phenotypically diverse disorder caused by deficiencies in the synthesis of type I collagen. We present hereby a case of a pregnant woman with osteogenesis imperfecta and hypopituitarismus. Pregnancy was achieved with IVF procedure, and hypertension occurred in the 32nd gestational week of pregnancy. A multidisciplinary team approach was mandatory and resulted in the delivery of a live baby girl in the 37th gestational week of pregnancy. The successful outcome of this high-risk pregnancy and delivery can be attributed to collaboration between different specialty teams and planning for the known complications that may affect pregnancy and delivery in women with these genetic skeletal disorders.

Keywords: hypopituitarismus, osteogenesis imperfecta, pregnancy, childbirth

References

1. Sillence DO, Senn A, Danks DM. Genetic heterogeneity in osteogenesis imperfecta. J Med Genet. 1979;16(2):101-116. doi: 10.1136/jmg.16.2.101.
2. Lyra TG, Pinto VA, Ivo FA, Nascimento J dos S. Osteogenesis imperfecta in pregnancy. Case report. Rev Bras Anestesiol. 2010 May-Jun;60(3):321-324. doi: 10.1016/S0034-7094(10)70040-4.
3. Shulman R, Ellis J, Shore E, Kaplan F, Badell M. Maternal genetic skeletal disorders: lessons learned from cases of maternal osteogenesis imperfecta and fibrodysplasia ossificans progressiva. J Clin Gynecol Obstet. 2015;4:184-187. doi: 10.14740/jcgo306w.
4. Kumar V, Abbas A, Aster J. Robbins and Cotran pathologic basis of disease. 9th ed. Philadelphia, PA: Elsevier; 2015. p. 1203.
5. Chamunyonga F, Masendeke KL, Mateveke B. Osteogenesis imperfecta and pregnancy: a case report. J Med Case Rep. 2019 Dec 11;13(1):363. doi: 10.1186/s13256-019-2296-0.
6. Ruiter-Ligeti J, Czuzoj-Shulman N, Spence AR, Tulandi T, Abenhaim HA. Pregnancy outcomes in women with osteogenesis imperfecta: a retrospective cohort study. J Perinatol. 2016 Oct;36(10):828-831. doi: 10.1038/jp.2016.111.
7. Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY, editors. Williams obstetrics.25th ed. McGraw Hill; 2018.Available from: https://accessmedicine.mhmedical.com/content.aspx?bookid=1918§ionid=185041518.
8. McCarthy EF. Genetic diseases of bones and joints. Semin Diagn Pathol. 2011;28(1):26-36. doi: 10.1053/j.semdp.2011.01.004.
9. Chetty SP, Shaffer BL, Norton ME. Management of pregnancy in women with genetic disorders, Part 1: Disorders of the connective tissue, muscle, vascular, and skeletal systems. Obstet Gynecol Surv. 2011;66(11):699-709. doi: 10.1097/OGX.0b013e31823cdd50.
10. Biggin A, Munns CF. Osteogenesis imperfecta: diagnosis and treatment. Curr Osteoporos Rep. 2014;12(3):279-288. doi: 10.1007/s11914-014-0225-0.
11. Murray S, Shamsuddin W, Russell R. Sequential combined spinal-epidural for caesarean delivery in osteogenesis imperfecta. Int J Obstet Anesth. 2010;19(1):127-128. doi: 10.1016/j.ijoa.2009.07.009.