What vitamins are typically added during hyperemesis gravidarum management to address suboptimal intake and prevent complications?

• A. Vitamin B6 and B12, thiamine, and folic acid
• B. Vitamin C only
• C. Vitamin A and D only
• D. No vitamins

Answer: (A)

When intake is suboptimal in hyperemesis gravidarum, providing targeted vitamins helps prevent common deficiencies and serious complications for both mother and fetus. The most appropriate supplementation includes vitamin B6 (pyridoxine) and vitamin B12 to support hematologic health and help with nausea, thiamine (vitamin B1) to prevent Wernicke’s encephalopathy in the setting of poor intake (especially before glucose administration), and folic acid to support neural tube development and DNA synthesis.

The other options don’t address these risks: vitamin C alone doesn’t prevent anemia or neural tube issues; vitamin A and D alone aren’t sufficient and high vitamin A can be teratogenic; and withholding vitamins altogether ignores the likelihood of micronutrient deficiencies during prolonged vomiting.