Hyperemesis gravidarum complicated by Wernicke's encephalopathy.
BACKGROUND
Wernicke's encephalopathy is usually associated with alcohol abuse, but can also occur with hyperemesis gravidarum. The effect of delay in thiamine replacement on fetal outcomes is unknown. We present a case of this complication.


METHODS
A primipara with hyperemesis was admitted for mental status changes in her 14th week of pregnancy. Physical examination revealed a lethargic patient with ophthalmoplegia, ataxia, and hyporeflexia. Parenteral thiamine therapy was started. The patient improved rapidly although the ataxia persisted. A spontaneous abortion occurred 2 weeks later.


CONCLUSIONS
Wernicke's encephalopathy can complicate hyperemesis gravidarum. Early thiamine replacement may decrease the chances of spontaneous abortion.
Spruill
Steven C
SC
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Kuller
Jeffrey A
JA
D000022:Abortion, Spontaneous; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy; D011261:Pregnancy Trimester, First; D013831:Thiamine / Q000008:administration & dosage; D014899:Wernicke Encephalopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D013831:Thiamine