Complications
Mallory-Weiss tears occur with forcible vomiting.[47] They represent mucosal tears at the lower esophageal sphincter. They are typically self-limited and should be treated conservatively.
Patients with hyperemesis have an increased risk (odds ratio 1.5) of developing preeclampsia.[43]
Rarely, splenic avulsion is associated with hyperemesis. It is most likely caused by forcible vomiting. Prompt surgical intervention is required.[48]
Patients with hyperemesis have an increased risk (odds ratio 1.4) of their fetus developing intrauterine growth restriction.[43]
While extremely rare, epidemiologic data indicate that fetal death rate in pregnancies complicated by hyperemesis is higher than in those without hyperemesis.[46]
Wernicke encephalopathy occurs in patients with severe thiamine deficiency, which may result from severe NVP.[51] Symptoms typically include nystagmus, headache, vertigo, decreased level of consciousness, and ataxia. It may be prevented in patients at risk if thiamine is administered to severely dehydrated patients prior to the administration of glucose-containing solutions.[2]
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