Sacral Stress Fracture in Pregnancy: Case Report and Review of Literature

Sacral stress fractures (SSF) are one of the rare causes of lumbar and hip pain during pregnancy. The purpose of this report is to present a case of SSF diagnosed in the second trimester of pregnancy along with its diagnosis and treatment as wells as the type of birth. A 27-year-old primigravid patient presented with lumbar and hip pain at 25 weeks of gestation. Magnetic resonance imaging revealed SSF. The patient was followed up with conservative treatment. She gave birth by caesarean section at 38 weeks of gestation. Bone mineral density analysis revealed pregnancy-related osteoporosis in the postpartum period. Two months later, the patient’s symptoms were completely resolved. SSF should be considered in the differential diagnosis of lumbar and hip pain during pregnancy, and it should be kept in mind that these fractures may also occur in the prepartum period. Pregnancy-related osteoporosis is a risk factor for SSF. Caesarean section can be recommended as the type of birth in the women with SSF while considering the possible displacement risk for the fracture. to the best of our knowledge, only three cases are reported during the prepartum period (1,4,8). SSF diagnosis can be delayed due to its rarity and unknown etiology and is included in the differential diagnosis of lumbar and hip pain in pregnant women. It is diagnosed via a vertical fracture line in the sacrum and edema in the surrounding bone as revealed by magnetic resonance imaging (MRI) (4,9). Difficulties may be experienced in prepartum SSF treatment due to pregnancy; the question of which type of birth should be performed in these patients remains controversial (1,4). Herein, we present a case of prepartum SSF and discuss these patients with their treatment and type of birth. Abstract