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Treatment resistant hyperemesis gravidarum in a patient with type 1 diabetes mellitus: neonatal withdrawal symptoms after successful antiemetic therapy with mirtazapine

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Abstract

Here we present the case of a 30-year-old woman with type I diabetes mellitus, preeclampsia and treatment resistant persistent hyperemesis gravidarum in her 25th week of gestation who was successfully treated with the antidepressant mirtazapine (Remergil©). Nausea and vomiting resolved within 5 days. After discharge from the hospital in 28 weeks of gestation and discontinuation of the medication on her own initiative a relapse occurred, once again with good response to mirtazapine. The drug was continued until birth. At 34 + 0 weeks a cesarian section was performed due to fetal growth restriction and deteriorating preecplampsia. During the second and fourth day postnatal age the child temporarily developed hyperarousal which could be explained by mirtazapine withdrawal.

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Authors and Affiliations

  1. Department of Obstetrics and Prenatal Medicine, University Clinics of Bonn, Bonn, Germany

    V. Schwarzer & U. Gembruch

  2. Department of Neonatology, University Clinics of Bonn, Bonn, Germany

    A. Heep

  3. Department of Psychosomatics in Gynecology, University Clinics of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    A. Rohde

Authors
  1. V. Schwarzer
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  2. A. Heep
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  3. U. Gembruch
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  4. A. Rohde
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Correspondence to A. Rohde.

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Schwarzer, V., Heep, A., Gembruch, U. et al. Treatment resistant hyperemesis gravidarum in a patient with type 1 diabetes mellitus: neonatal withdrawal symptoms after successful antiemetic therapy with mirtazapine. Arch Gynecol Obstet 277, 67–69 (2008). https://doi.org/10.1007/s00404-007-0406-5

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  • DOI: https://doi.org/10.1007/s00404-007-0406-5

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