Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 5 ( September-October, 2023 ) > List of Articles

CASE REPORT

Wernicke's Encephalopathy: A Rare Complication of Hyperemesis Gravidarum

Krutika Vivek Bhalerao, Sandhya Pajai

Keywords : Ataxia, Case report, Hyperemesis gravidarum, Mental confusion, Thiamine, Wernicke's encephalopathy

Citation Information : Bhalerao KV, Pajai S. Wernicke's Encephalopathy: A Rare Complication of Hyperemesis Gravidarum. J South Asian Feder Obs Gynae 2023; 15 (5):607-609.

DOI: 10.5005/jp-journals-10006-2095

License: CC BY-NC 4.0

Published Online: 31-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: A case of Wernicke's encephalopathy (WE) due to hyperemesis gravidarum is presented for its rarity and favorable outcome of pregnancy due to timely diagnosis and management. Background: Wernicke's encephalopathy is a rare reversible neurological complication of hyperemesis gravidarum due to vitamin B1 (thiamine) deficiency. Hyperemesis gravidarum (HG) is associated with prolonged starvation and electrolyte imbalance leading to Wernicke's encephalopathy, which is a triad of ocular signs, ataxia, and confused mental state. It also leads to a serious complications like central pontine myelinolysis (CPM). During pregnancy, Wernicke's encephalopathy has poor outcomes in mother and baby. A fifth gravida presented at 14 weeks of gestation with Wernicke's encephalopathy was treated with thiamine, recovered after 34 days, and delivered by cesarean section at 36.5 weeks, a live healthy baby. Conclusion: A favorable outcome of pregnancy can be there with a high index of suspicion, timely diagnosis, and management with thiamine. Clinical significance: Immediate supplementation of thiamine in antenatal women with prolonged vomiting in pregnancy, especially before starting intravenous glucose can prevent this reversible neurological condition.


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