A 30-year-old primigravida with a single intrauterine pregnancy at 16+1 weeks’ gestation
based on last menstrual period (and consistent with an 11-week ultrasound) presented
to the emergency department (ED) with protracted nausea and vomiting. Although the
patient had not received prenatal care, she had been evaluated in the ED for nausea
and vomiting at 11 and 14 weeks’ gestation. She was discharged home from the most
recent ED visit after tolerating oral intake and receiving a combination of intravenous
(IV) antiemetics and oral potassium repletion. During the current visit, the patient
was found to have had a cumulative 60-lb weight loss (13.8% of prepregnancy weight),
hypokalemia (2.0 mmol/L), hypomagnesemia (0.1 mmol/L), hypocalcemia (0.3 mmol/L),
and elevated liver enzymes (aspartate transaminase [AST], 109 IU/L; alanine transaminase
[ALT], 392 IU/L). She was admitted to the hospital for electrolyte repletion and IV
fluids but was transferred to the labor and delivery unit after a second-trimester
fetal demise was diagnosed and confirmed by ultrasonography.
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References
- Wernicke’s encephalopathy in hyperemesis gravidarum: a systematic review.Eur J Obstet Gynecol Reprod Biol. 2019; 236: 84-93
- Neglected woman with hyperemesis gravidarum leading to Wernicke encephalopathy.BMJ Case Rep. 2020; 13e238545
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Article Info
Publication History
Published online: April 05, 2022
Footnotes
The authors report no conflict of interest.
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© 2022 Elsevier Inc. All rights reserved.
