How does hyperemesis gravidarum cause Wernicke encephalopathy?

How does hyperemesis gravidarum cause Wernicke encephalopathy?

Wernicke’s encephalopathy (WE) due to causes other than chronic alcohol abuse is an uncommon and often misdiagnosed condition. In the setting of hyperemesis gravidarum, an acute deficiency of thiamine results from body stores being unable to meet increased metabolic demands.

Can severe hyperemesis gravidarum cause encephalopathy?

[1] Hyperemesis gravidarum is a severe complication of pregnancy characterized by intractable nausea, vomiting, dehydration, and weight loss, that affects 0.3–2.0% of pregnant women. [2] If hyperemesis gravidarum is not well controlled, it can lead to Wernicke’s encephalopathy.

Can hyperemesis cause Wernicke’s Encephalopathy?

Wernicke’s encephalopathy is a rare complication of hyperemesis gravidarum. It should be diagnosed as early as possible to prevent long-term neurological sequela or death. Thiamine supplementation in pregnant women with prolonged vomiting should be initiated, especially before parenteral dextrose infusion.

What are possible complications of hyperemesis gravidarum?

Complications of Hyperemesis Gravidarum The main risks to women with hyperemesis gravidarum are dehydration, electrolyte imbalances, and weight loss. Women with prolonged hyperemesis gravidarum are at greater risk for preterm labor and preeclampsia, according to the HER Foundation.

Why do you give thiamine in hyperemesis?

WE is a potentially reversible condition if treated early. Thiamine supplementation is crucial for women with HG. Moreover, replacement of electrolytes and glucose homeostasis is also important to prevent CPM. CPM occurs probably due to hypokalemia, hypernatremia and hyperosmolality in hyperemesis.

Why is dextrose contraindicated in hyperemesis gravidarum?

Expert opinion remains that dextrose-containing solutions should be avoided, given the theoretical risk of precipitating Wernicke’s encephalopathy in those who are thiamine deficient, or central pontine myelinolysis in those with hyponatraemia.

What are two potential complications of hyperemesis gravidarum?

Is hyperemesis gravidarum harmful to the baby?

Will hyperemesis gravidarum harm my baby? HG can make you feel very unwell, but it’s unlikely to harm your baby if treated effectively. However, if it causes you to lose weight during pregnancy, there is an increased risk that your baby may be born smaller than expected (have a low birthweight).

What are the causes of Wernicke’s encephalopathy ( WE )?

Wernicke’s encephalopathy (WE) occurs in the setting of thiamine deficiency. It is often precipitated by chronic alcoholism but can be attributed to metabolic changes and malnutrition caused by hyperemesis gravidarum in the context of pregnancy (Talib et al., 2018).

How is Wernicke’s encephalopathy treated during pregnancy?

The neurological signs and the MRI findings pointed to a diagnosis of Wernicke’s encephalopathy. The patient was treated with intramuscular vitamin B1 followed by oral thiamine until the end of pregnancy. The subsequent course of the pregnancy was uncomplicated, and resulted in the delivery of a healthy 2970 g male infant.

What are the signs and symptoms of encephalopathy?

The encephalopathy is characterized by profound disorientation, indifference, and inattentiveness. Some patients exhibit an agitated delirium related to ethanol withdrawal. Ocular motor abnormalities include nystagmus, lateral rectus palsy, and conjugate gaze palsy.