Lammers Sydney, Iovino Nicholas A, Pusateri Antoinette, Snyder Andrea, Butnariu Madalina, Frey Heather A, Skeans Jacob
Department of Obstetrics and Gynecology and the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, and The Ohio State University College of Medicine, Columbus, Ohio.
Obstet Gynecol. 2025 Apr 1;145(4):e127-e130. doi: 10.1097/AOG.0000000000005870. Epub 2025 Mar 6.
Patients with inflammatory bowel disease, particularly Crohn disease (CD), are at increased risk of fat malabsorption and fat-soluble vitamin deficiencies. Vitamin K is a fat-soluble vitamin that plays a critical role in blood coagulation. Vitamin K deficiency during pregnancy can lead to severe maternal and neonatal hemorrhagic complications.
We report the case of a patient with severe CD requiring extensive bowel resection who acquired vitamin K deficiency during pregnancy. During pregnancy, the patient experienced epistaxis, easy bruising, and intermittent gum bleeding. The patient and neonate experienced significant hemorrhagic morbidity secondary to vitamin K deficiency after cesarean delivery at 35 3/7 weeks of gestation for nonreassuring fetal well-being.
Vitamin K deficiency is a rare complication of CD that can result in life-threatening maternal and neonatal outcomes. Clinicians caring for patients with severe CD with prior bowel resection and risk factors for fat malabsorption should consider screening for vitamin K deficiency during pregnancy.
炎症性肠病患者，尤其是克罗恩病（CD）患者，脂肪吸收不良和脂溶性维生素缺乏的风险增加。维生素K是一种脂溶性维生素，在血液凝固中起关键作用。孕期维生素K缺乏可导致严重的母婴出血并发症。
我们报告一例重度CD患者，因广泛肠切除术后在孕期出现维生素K缺乏。孕期，该患者出现鼻出血、易瘀伤和间歇性牙龈出血。因胎儿情况不佳，孕35 3/7周行剖宫产，术后患者及新生儿因维生素K缺乏出现严重出血并发症。
维生素K缺乏是CD的一种罕见并发症，可导致危及生命的母婴结局。对于有肠切除史且存在脂肪吸收不良风险因素的重度CD患者，临床医生在孕期应考虑筛查维生素K缺乏情况。
