Jaundice Caused by Hyperemesis Gravidarum
Issued Date
2022-12-01
Resource Type
ISSN
15245012
Scopus ID
2-s2.0-85144236806
Journal Title
Ochsner Journal
Volume
22
Issue
4
Start Page
372
End Page
378
Rights Holder(s)
SCOPUS
Bibliographic Citation
Ochsner Journal Vol.22 No.4 (2022) , 372-378
Suggested Citation
Pornchai A., Kamalaporn P., Sriphrapradang C. Jaundice Caused by Hyperemesis Gravidarum. Ochsner Journal Vol.22 No.4 (2022) , 372-378. 378. doi:10.31486/toj.22.0019 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87160
Title
Jaundice Caused by Hyperemesis Gravidarum
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Hyperemesis gravidarum is characterized by intractable vomiting and associated with weight loss exceeding 5% of prepregnancy body weight, dehydration, and ketosis. Hyperemesis gravidarum occurs during the first trimester and typically resolves by 16 to 20 weeks of gestation. Approximately half of all hospitalized females with hyperemesis gravidarum have a mild elevation in liver enzymes; however, jaundice and hepatic synthetic dysfunction are uncommon. Case Report: A 22-year-old gravida 1 para 0 in her ninth week with a singleton gestation was hospitalized with persistent nau-sea, vomiting, weight loss of 11% of her prepregnancy body weight, dehydration, hypokalemia, and jaundice. Liver function tests showed hyperbilirubinemia of 7.1 mg/dL and alanine aminotransferase levels high as 676 U/L. Other hepatobiliary diseases were excluded. Thyroid function tests revealed thyrotoxicosis. Gestational thyrotoxicosis is often associated with hyperemesis gravi-darum because of their shared pathophysiology of high human chorionic gonadotropin levels during the first trimester. After supportive management including hydration, correction of electrolyte disturbance, vitamin supplementation, and antiemetic treat-ment, the patient’s symptoms resolved. Liver and thyroid dysfunction returned to normal after resolution of vomiting. The patient delivered a healthy child at 38 weeks’ gestation. Conclusion: Elevation of aminotransferase and bilirubin levels may occur in patients with hyperemesis gravidarum. Although jaundice and highly elevated liver enzymes have been reported, investigations to exclude preexisting and concurrent liver diseases are required. Management of hyperemesis gravidarum is supportive, and outcomes are generally favorable.
