Introduction Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting seen in women during pregnancy and often results in hospital admission.
Case Description A 33 year old Caucasian woman in her first pregnancy, presented at 13 weeks gestation with a 6 weeks history of significant vomiting and weight loss of 6 kgs. She was admitted as she had not responded to oral antiemetics. During her admission she was managed with parenteral antiemetics, steroids and anti-thrombotics. She was found have a deranged clotting profile but a normal platelet count and liver function tests with no signs or symptoms of bleeding diatheses. The clotting profile was rapidly corrected after parenteral treatment with Vitamin K suggesting a Vitamin K deficiency consequent to hyperemesis.
Discussion Hyperemesis gravidarum is a serious condition that can result in electrolyte, fluid and nutritional deficiencies. In particular, liver dysfunction has been associated with the condition; however it is not well understood. It should be noted that clotting profile can also be affected by this condition, as seen in this case. Management of HG focuses mainly on rehydration, but it is important to consider and correct nutritional deficiencies and any electrolyte imbalances that may result.
Conclusion Although, there are very few reports of Vitamin K deficiency, it should be taken into consideration, particularly in cases of intractable HG. The severity of nutritional deficiency and weight loss seen in these patients may warrant prophylactic administration of vitamin K to prevent coagulopathy or bleeding diathesis.
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