Coagulopathy Secondary to Vitamin K Deficiency in Hyperemesis Gravidarum

Vitamin K deficiency in hyperemesis gravidarum as a potential cause of fetal intracranial hemorrhage and hydrocephalus

“…Vitamin K deficiency causes a decrease in the levels of all prothrombin complex proteins. The fall in factor VII causes a prolonged PT (Robinson et al, 1998). This case also demonstrated liver dysfunction.…”

“…Vitamin K deficiency is a known complication of malnutrition as well as a known cause of coagulopathy (Niiya et al, 1983). In hyperemesis gravidarum, there is only one previous case in the literature demonstrating maternal vitamin K deficiency (Robinson et al, 1998). However, to our knowledge, this is the first report showing fetal intracranial hemorrhage that was probably associated with vitamin K deficiency resulting in hydrocephalus in a case of hyperemesis gravidarum.…”

“…Thus, we can speculate that massive intraventricular hemorrhage resulted in nonobstructive hydrocephalus. Fourth, IVH for this patient did not contain vitamin K. Therefore, physicians must pay special attention to whether IVH includes vitamin K as well as other vitamins, particularly in patients with long-term persistent hyperemesis gravidarum complicated by liver dysfunction, such as in this case (Robinson et al, 1998).…”

“…First, PT is a vitamin K-dependent coagulation factor (Niiya et al, 1983;Penzias and Treisman, 1998;Clarke et al, 2005). Clotting factors II, VII, IX, and X require vitamin K for biological activity (Robinson et al, 1998). These proteins are synthesized in the liver.…”

“…In such patients, particularly in those with liver dysfunction, we must regularly check PT and/or vitamin K levels, as well as monitor the fetus for intracranial hemorrhage. Then, if necessary, it may be prudent to consider prophylactic vitamin K supplementation before a problem presents (Robinson et al, 1998).…”