Maternal and Neonatal Hemorrhage From Vitamin K Deficiency in the Setting of Crohn Disease in Pregnancy.

Abstract

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.