In malnourished women with hyperemesis gravidarum who require specialized nutrition support, which nutrient supplementation is most likely required?

• A. Thiamin
• B. Chloride
• C. Vitamin E
• D. Manganese

Answer: (A)

The key issue is preventing thiamine deficiency when starting nutrition support in a severely malnourished patient who is also experiencing hyperemesis gravidarum. Thiamine (vitamin B1) is essential for carbohydrate metabolism, and stores in the body are small. When glucose-containing feeds are begun in someone with depleted thiamine, the risk of deficiency rises quickly and can lead to Wernicke’s encephalopathy and other complications. Pregnant women with hyperemesis gravidarum have increased metabolic demands and poor intake, making thiamine repletion a priority before or with carbohydrate refeeding. Chloride is mainly an electrolyte that may be disrupted with vomiting but is not the nutrient most likely required specifically for deficiency prevention in this scenario. Vitamin E and manganese are less commonly implicated as immediate needs in this context.