Asymptomatic Osteomalacia in Pregnancy

Abstract

Background:
Alkaline phosphatase (ALP) is important enzyme in diagnosis many diseases like osteomalacia. It presents in defect isoenzyme including bone, liver, and placental ALP.  
Aims of this study:
Assess the efficacy of the bone ALP enzyme and intact parathyroid hormone  (iPTH)  to  detect  the  possible  presence  of  osteomalacia  in pregnant women due to the vitamin D deficiency. 
Objective:  
Evaluate the nutritional state of pregnant women that will affect the good health of her bone and preparing her for lactation stage.
Methods:
Blood samples were collected from 87 normal fasting pregnant women then subdivided them into three subgroups according to their period of gestation. ALP and its isoenzyme were determined calorimetrically after separation  of  them  by  thermal  stability  method,  and  the  level  of parathyroid  hormone  was  measured  for  36  of  them  from  different subgroups by the ELISA technique. Statistical test used as t-test (student test) and leaner regression . 
Results:
There was a difference in the activity rates of the heat labile enzyme (HLAP), which is mostly related to the bones when compared between groups, and showed that there is a positive relationship between the activity of this enzyme with the activity of the placental isoenzyme and with the gestational age. PTH showed an increasing in its level and a direct proportion with placental isoenzyme. 
Conclusion and recommendation: 
 Increased bone (ALP) isoenzyme, and elevated PTH could be a marker of  osteomalacia  in  pregnancy,  accordingly,  we  recommend  a measurement  of  parathyroid  hormone  and  placental,  bone  ALP  in pregnant women to ensure the health of the placenta and bone.