Source
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA. jnrobinson@bics.bwh.harvard.edu
Abstract
BACKGROUND:
Hyperemesis gravidarum is a condition of pregnancy characterized by excessive nausea and vomiting, which can be associated with malnutrition. Vitamin K deficiency is a known complication of malnutrition as well as a known cause of coagulopathy. To date, there is no reported case in the literature of vitamin K deficiency in hyperemesis gravidarum.
CASE:
A woman at 15 weeks' gestation presented with hyperemesis gravidarum complicated by an episode of severe epistaxis. Investigation revealed coagulopathy secondary to vitamin K deficiency. The coagulopathy resolved after vitamin K replacement, with complete correction of all clotting factors.
CONCLUSION:
Vitamin K deficiency and coagulopathy should be considered in women with hyperemesis gravidarum who present with a bleeding diathesis. Prophylactic vitamin K replacement should be considered in cases in which hyperemesis is severe and protracted.