Clinical awareness for health care professionals: Fatal encephalopathy complicating persistent vomiting in pregnancy.
S Afr Med J
; 106(8): 792-4, 2016 Jul 08.
Article
em En
| MEDLINE
| ID: mdl-27499405
ABSTRACT
Women with persistent vomiting during pregnancy need early referral to appropriate health facilities. Delayed referral and inappropriate management may lead to metabolic encephalopathy from a variety of causes, including electrolyte derangements or thiamine deficiency (Wernicke's encephalopathy) (WE). We present a case of persistent vomiting in pregnancy in which there was delayed referral, inappropriate treatment and failure to associate neurological signs such as terminal neck stiffness with WE, resulting in poor fetomaternal outcomes. In this report, we discuss the following lessons (i) the need for early transfer of a patient with persistent vomiting and enigmatic clinical features to a higher healthcare facility; (ii) failure to associate neurological signs with complications of hyperemesis gravidarum/WE; (iii) lack of thiamine supplementation; and (iv) the advantages of magnetic resonance imaging over a computed tomography scan in the diagnosis of WE.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Encefalopatia de Wernicke
/
Diagnóstico Tardio
/
Hiperêmese Gravídica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Idioma:
En
Revista:
S Afr Med J
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
África do Sul