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Ollier's disease complicating pregnancy

Case report A 20 year old primigravida was seen at 37þ weeks of gestation. She was married to her first cousin and gave a history of multiple bone overgrowths especially in the lower limb but no history of fractures. She had been diagnosed as having enchondromatosis (Ollier’s disease) as a child. There was no other significant past personal or family history. On examination, non-tender exostoses were noticed in the phalanges of the upper limb and in the long bones of the lower limb. Abdominal examination revealed a wellgrown fetus corresponding to gestation. Routine investigations (haemoglobin, blood group and Rhesus typing, rubella, Hepatitis, HIV status) were normal. She presented again at 38þ weeks of gestation in early labour. Vaginal examination revealed a high presenting part with tense bulging membranes. Some prominence of the bone into the pelvic canal was felt and the membranes were left intact. She declined caesarean section initially. A repeat examination in 4 hours revealed the dilatation of the cervix was 6 cm with high presenting part and the bony prominence was felt on the right side obstructing the pelvic capacity. She was counselled about the possibility of cord prolapse and caesarean section if the membranes were ruptured. Controlled rupture of the membranes was done but loops of cord were felt by the side of the head. An emergency caesarean section was performed and a baby boy weighing 3170 g was delivered with Apgar score of 8 and 9 at 1 and 5 minutes, respectively. She had an uneventful post-operative recovery and was discharged on the fifth post-operative day. Six weeks later, an X-ray of the pelvis showed Ollier-related changes in both hips, pubic bones, left and right iliac bones and a narrow pelvic canal (Fig. 1). Discussion