Intraperitoneal Hemorrhage in a Pregnant Woman with Hyperemesis Gravidarum: Vitamin K Deficiency as a Possible Cause

Abstract EN

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 105/7 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 166/7 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.