[Osteoporosis in all young daughters of a mother with multiple osteoporotic fractures. A case of familial osteoporosis]

We herein describe a family whose female members are all osteoporotic: a postmenopausal mother and her three premenopausal daughters. The mother aged 60 presented axial and peripheral fractures, and very low bone mineral density (BMD). She reported that her grandmother had suffered a hip fracture. The eldest daughter aged 30 suffered multiple vertebral fractures during pregnancy and lactation associated with very low BMD. In view of these observations, the other two daughters aged 29 and 27 years respectively were evaluated. BMD was found to be severely diminished according to densitometric values for osteoporosis established by WHO, but they had no history of bone fractures. Probably the strong genetic component in bone mass is responsible for the severely diminished BMD observed in all the women in this family, as well as the occurrence of bone fractures in two of them. To our knowledge, there are no similar reports in the literature. Our results evidence the importance of evaluating bone mass in the offspring of an individual presenting severe osteoporosis, in order to detect family members with low bone mass and at high risk of developing bone fractures.

Vertical position during the first stage of the course of labor, and neonatal outcome

This study included 369 normal term labors. In 145 cases the women were sitting, standing or walking at will during the first stage, whereas 224 remained lying in bed during the whole labor. When the mother remains in the 'vertical position during the first stage of labor (1) the physiological timing of the spontaneous rupture of membranes is not altered, (2) duration of the first stage is shortened in 25%--this shortening may reach 34% in the nulliparas, (3) cephalic molding is not increased, (4) the incidence of forceps delivery diminishes and (5) perinatal morbimortality is not increased.