Hyperemesis gravidarum and first trimester sagittal sinus thrombosis

Kennelly et al report a case of a 26-year-old, previously healthy primigravida who is presented to a tertiary care hospital at 11 weeks with a history of vomiting, headaches and tonic clonic seizures. The presence of an extensive thrombus within the superior sagittal sinus with secondary hemorrhage...

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Bibliographic Details
Published in:Journal of obstetrics and gynaecology 2008-05, Vol.28 (4), p.453-454
Main Authors: Kennelly, M. M., Baker, M. R., Birchall, D., Hanley, J. P., Turnbull, D. M., Loughney, A. D.
Format: Article
Language:English
Subjects:
Adult
Brain - diagnostic imaging
Female
Humans
Hyperemesis Gravidarum
Medical diagnosis
Pregnancy
Pregnancy Complications, Hematologic - diagnosis
Pregnancy Trimester, First
Sagittal Sinus Thrombosis - complications
Sagittal Sinus Thrombosis - diagnosis
Sinuses
Thrombolytic drugs
Thrombophilia - diagnosis
Tomography, X-Ray Computed
Vomiting
Womens health
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Summary:Kennelly et al report a case of a 26-year-old, previously healthy primigravida who is presented to a tertiary care hospital at 11 weeks with a history of vomiting, headaches and tonic clonic seizures. The presence of an extensive thrombus within the superior sagittal sinus with secondary hemorrhage in the right parietal lobe was seen on MRI. Her condition deteriorated and she was transferred to Neuroradiology for venography and direct catheter thrombolysis with tissue plasminogen activator (tPA). This strategy was effective with an improvement in the clinical condition with no evidence of systemic or uteroplacental bleeding. They conclude that consideration of age and intercurrent risk factors should alert the clinician to the synergistic effects of hyperemesis and an inherited thrombophilia. Thromboprophylaxis should be considered when a pregnant woman of any gestation, who is known to have a thrombophilic defect suffers vomiting leading to clinical evidence of dehydration.
ISSN:0144-3615
1364-6893
DOI:10.1080/01443610802131119