We report the case of a 19-year-old woman who consulted for low-back pain 3 weeks after her first delivery. This young woman
had a personal history of protein C deficiency and was treated daily during her pregnancy with low-molecular-weight heparin.
Her body mass index was 34 and she only gained 10 kg during her pregnancy. Since the delivery – which occurred without any
complication – she had suffered from a gradually increasing right-buttock pain and limp. Magnetic resonance imaging (MRI)
revealed a fracture of the right sacral ala. After analgesia and 1 month of home relative bed rest, the patient recovered
her functional capacities. Regarding our patient, who had no potential clinical risk factors for osteoporosis, the causal
effect of heparin is thus possible but not certain. This case report illustrates the fact that clinicians should have a high
suspicion of pelvic fracture in post-partum women, even in very young ones, presenting sudden onset of low back and pelvic
pain, especially when they have received heparin during pregnancy. MRI seems to be the key exam because it is able to detect
and stage fractures or microfractures.
Keywords Fracture - MRI - Pregnancy