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.