Intraperitoneal Hemorrhage in a Pregnant Woman with Hyperemesis Gravidarum: Vitamin K Deficiency as a Possible Cause.
Hyperemesis gravidarum can cause various vitamin deficiencies. Vitamin K deficiency can lead to coagulopathy or hemorrhagic diathesis. A nulliparous Japanese woman with hyperemesis gravidarum at 10(5/7) weeks was admitted with giant myoma, intestinal obstruction, and abdominal pain. Treatment for a degenerative myoma was instituted with intravenous antibiotics. The abdominal pain ameliorated, but intestinal obstruction persisted. At 16(6/7) weeks, we performed laparotomy for release of intestinal obstruction, when intraabdominal bleeding of 110 mL existed. Blood tests revealed coagulopathy secondary to vitamin K deficiency. The coagulopathy responded to intravenous vitamin K injection. Coagulopathy due to vitamin K deficiency can occur with hyperemesis gravidarum, and coexisting intestinal obstruction and broad-spectrum antibiotics can aggravate the deficiency.
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi 09216, Japan.
Yosuke
Y
Baba
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi 09216, Japan.
Hiroyuki
H
Morisawa
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi 09216, Japan.
Koyomi
K
Saito
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi 09216, Japan.
Hironori
0000-0003-1652-9438
H
Takahashi
Department of Surgery, Jichi Medical University, Tochigi 09216, Japan.
Kazuma
K
Rifu
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi 09216, Japan.
Shigeki
0000-0003-4378-221X
S
Matsubara