Coagulopathy secondary to vitamin K deficiency in hyperemesis gravidarum.
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.


METHODS
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.


CONCLUSIONS
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.
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA. jnrobinson@bics.bwh.harvard.edu
J N
JN
Robinson
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R
Banerjee
M P
MP
Thiet
D000328:Adult; D001778:Blood Coagulation Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications*; D011247:Pregnancy; D014812:Vitamin K / Q000627:therapeutic use; D014813:Vitamin K Deficiency / Q000150:complications* / Q000188:drug therapy
D014812:Vitamin K