Health Questions and Answers

Question: What are the maternal complications?


The most commonly reported serious complication associated with hyperemesis is Wernicke’s encephalopathy due to thiamine deficiency, sometimes associated with central pontine myelinolysis. A classic triad of ataxia, confusion, and oculomotor signs characterizes this syndrome. Women with prolonged vomiting should receive supplemental thiamine to prevent this dangerous complication.
Other complications related to prolonged vomiting include Mallory-Weiss tear, esophageal rupture, splenic avulsion, and peripheral neuropathy secondary to vitamin B6 and B12 deficiency.

  • Nausea and vomiting of pregnancy typically begins around the fourth to the seventh week and ends by the twelfth week.
  • Hyperemesis gravidarum may be associated with electrolyte imbalance, especially hyperchloremic metabolic acidosis, 5% weight loss, and persistent ketonuria.
  • The risk of first trimester loss is decreased in women with hyperemesis gravidarum and even with nausea and vomiting of pregnancy.
  • For women with severe, prolonged vomiting, supplemental thiamine should be given to prevent Wernicke’s encephalopathy.

Reference: Goodwin TM: Hyperemesis gravidarum. Clin Obstet Gynecol 41:597-605, 1998. Medline Similar articles Full article

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