Life‑threatening complications of hyperemesis gravidarum

Popa,Stefan L.; Barsan,Maria; Caziuc,Alexandra; Pop,Cristina; Muresan,Lucian; Popa,Luminita Celia; Perju‑Dumbrava,Lacramioara

doi:10.3892/etm.2021.10074

Life‑threatening complications of hyperemesis gravidarum

Authors:
- Stefan L. Popa
- Maria Barsan
- Alexandra Caziuc
- Cristina Pop
- Lucian Muresan
- Luminita Celia Popa
- Lacramioara Perju‑Dumbrava
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Affiliations: Second Medical Department, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj‑Napoca, Cluj‑Napoca 400000, Romania, Department of Occupational Health, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj‑Napoca, Cluj‑Napoca 400000, Romania, Department of Surgery, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj‑Napoca, Cluj‑Napoca 400000, Romania, Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj‑Napoca, Cluj‑Napoca 400349, Romania, Department of Cardiology, ‘Emile Muller’ Hospital, Mulhouse, 68200 Mulhouse, France, Department of Neurology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj‑Napoca, Cluj‑Napoca 400012, Romania
Published online on: April 16, 2021 https://doi.org/10.3892/etm.2021.10074
Article Number: 642
Copyright: © Popa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hyperemesis gravidarum (HG) refers to severe nausea and emesis noted during pregnancy. However, no consensus exists on the specific diagnostic criteria that can be used for this condition. The aim of the present systematic review was to summarize the available evidence regarding the severe complications observed during HG with a heightened risk of fatality. A systematic search was conducted on PubMed, Cochrane Library, EMBASE and WILEY databases for the relevant publications regarding the severe and life‑threatening complications of HG. The search terms were as follows: ‘(Hyperemesis gravidarum)’ AND (‘complications’ OR ‘severe’ OR ‘adverse pregnancy outcomes’ OR ‘stroke’ OR ‘seizures’ OR ‘Wernicke's encephalopathy’ OR ‘arrhythmias’ OR ‘pneumomediastinum’ OR ‘coagulopathy’ OR ‘electrolytic imbalance’). Abstracts, conference presentations, letters to the editor, studies written in languages other than English and editorials were all excluded. This search identified 43 studies analyzing life‑threatening complications of HG, of which 11, seven, eight and 17 articles analyzed neurological, cardiovascular, thoracic and systemic complications, respectively. Reports on life‑threatening complications were exceptionally rare in HG. The most frequent severe complications noted were Wernicke's encephalopathy, electrolyte imbalance and vitamin K deficiency. The low mortality rate for patients with HG over the last decade could be explained by the high efficiency of modern therapy, and the precise management of every complication according to current guidelines.

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