Vitamin K supplementation may prevent fetal risks in mothers with severe hyperemesis gravidarum: Study

A recent study illuminated the critical role of vitamin K (VK) in pregnancy, which revealed that maternal VK deficiency in cases of severe hyperemesis gravidarum, can lead to serious fetal complications, including cerebral hemorrhage and bone malformations. The research published in the Journal of Obstetrics and Gynaecology Research found the importance of monitoring and addressing VK deficiency to protect maternal and fetal health.

The research focused on analyzing changes in coagulation markers (prothrombin time (PT) and protein induced by VK absence or antagonist II)in patients with severe hyperemesis gravidarum. This condition was characterized by excessive vomiting during pregnancy, often leads to nutritional deficiencies, including VK.

A group of 151 patients with severe hyperemesis gravidarum receiving intravenous nutrition was compared with 46 control patients who underwent cervical suturing or benign ovarian tumor surgery before mid-pregnancy. These results revealed significant shifts in coagulation factors among the hyperemesis group

Prothrombin time (PT) was notably prolonged (14.6 ± 1.4 s) in the hyperemesis group which marked a significant move toward fibrinolysis when compared to controls (p < 0.001). Other markers, including prothrombin activity, INR, and APTT, showed changes but remained within the normal range.

The study identified a strong correlation between PT prolongation and elevated protein induced by VK absence or antagonist II (PIVKA-II) levels, an indicator of VK deficiency. In severe cases, VK supplementation in 4 patients rapidly corrected PT and PIVKA-II levels, underlining the reversible nature of the deficiency when timely intervention is provided.

These findings highlighted the importance of proactive screening for VK deficiency in patients with severe hyperemesis gravidarum. PT (s) and PIVKA-II serve as reliable markers to detect and monitor VK deficiency which enabled timely intervention. By addressing VK deficiency early, healthcare providers can potentially reduce the risk of fetal complications, like bleeding disorders and skeletal abnormalities, associated with maternal VK deficiency.

The study emphasizes that while hyperemesis gravidarum is often treated with intravenous nutrition, the inclusion of VK supplementation in cases with evident deficiency can significantly improve maternal and fetal outcomes. Overall, this research reinforces the need for increased awareness of vitamin K’s role during pregnancy, particularly in cases of severe hyperemesis gravidarum.

Reference:

Ouchi, N., Kuwabara, Y., Yonezawa, M., Ogawa, J., Kasano, S., Kato, M., Kurashina, R., Ichikawa, T., Kawabata, I., & Suzuki, S. (2025). Prolonged prothrombin time in hyperemesis gravidarum as an indicator of vitamin K deficiency. In Journal of Obstetrics and Gynaecology Research (Vol. 51, Issue 1). Wiley. https://doi.org/10.1111/jog.16198