Department of Obstetrics Gynecology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Shandong, 250012, Jinan, China.
BMC Pregnancy Childbirth. 2021 May 9;21(1):366. doi: 10.1186/s12884-021-03821-6.
Hyperemesis gravidarum (HG) is a common complication during pregnancy, however, HG associated simultaneous onset of blood cell destruction due to electrolyte abnormalities is rare. In this case, a woman with refeeding syndrome (RFS) secondary to electrolyte abnormalities caused by severe HG was diagnosed and managed in our hospital.
A 29-year old woman was sent to the local hospitals because of severe HG with appetite loss, weight reduction, general fatigue, and she was identified to have severe electrolyte abnormalities. However, the electrolyte abnormalities were not corrected promptly, and then she had the symptoms of stillbirth, altered mental status, visual hallucination, hemolytic anemia and thrombocytopenia. After transferred to our hospital, we continued to correct the electrolyte abnormalities and the labor induction was performed as soon as possible. The symptoms of blood cell destruction were relieved obviously, and the patient discharged four days later. The electrolyte disturbances and physio-metabolic abnormalities caused by HG helped us diagnose this case as RFS.
This case emphasizes that patients with RFS should be diagnosed appropriately and intervened promptly in order to prevent electrolyte imbalance induced blood cell destruction.
妊娠剧吐(HG)是妊娠期间常见的并发症,但由于电解质异常导致血细胞破坏同时发生的 HG 较为罕见。在本案例中,我们医院诊断并治疗了一名因严重 HG 导致电解质异常而继发再喂养综合征(RFS)的患者。
一名 29 岁女性因严重 HG 导致食欲下降、体重减轻、全身乏力而被送往当地医院,被诊断为严重电解质异常。然而,电解质异常未能及时纠正,继而出现死胎、意识改变、幻视、溶血性贫血和血小板减少。转至我院后,我们继续纠正电解质异常,并尽快进行引产。血细胞破坏的症状明显缓解,患者四天后出院。HG 引起的电解质紊乱和生理代谢异常有助于我们诊断为 RFS。
该病例强调,应适当诊断 RFS 患者并及时干预,以预防电解质失衡引起的血细胞破坏。