Clinical Presentation and Treatment of Hyperemesis Gravidarum in a Lady Carrying Twins in the First Trimester: A Case Reports

We report a 12-week-old pauci-geste carrying twins who experienced potentially fatal hyperemesis gravidarum. Clinical and paraclinical investigations revealed severe hypovolemic shock/dehydration, ionic disruption, undernutrition, and acute renal failure (GFR: 36.8 mL/min/1.73 m² according to modified MDRD). The patient spent almost 3 weeks in emergency and critical care at the University Clinics of Bukavu, where her pregnancy was tracked until her twins were born. Hyperemesis gravidarum diagnosis remains clinical, with incomplete etiopathogenesis understanding. Genetic research, including Growth Differentiation factor 15, is promising. Maternal morbidity consensus exists, but fetal effects vary by severity. Early multimodal approaches, psychological support, viral screening, Non-Invasive Prenatal Testing, nutraceuticals, and long-term Frozen Embryo Transfer child follow-up are vital for life-saving outcomes.