Vaknin Zvi, Halperin Reuvit, Schneider David, Teitler Jack, Dar Peer, Herman Amir, Herman Arie, Berkovitch Matitiahu
Departments of Obstetrics and Gynecology, Clinical Pharmacology and Toxicology Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
J Reprod Med. 2006 Aug;51(8):623-7.
To evaluate central nervous system abnormalities in a group of otherwise healthy pregnant women with hyperemesis gravidarum (HG) during the first trimester.
In a case-control study, 17 pregnant women with HG during the first trimester (study group) were compared with 18 pregnant women without nausea and vomiting in pregnancy (NVP). The latter group included women who were planning first-trimester termination of pregnancy for reasons other than health (control group). All the pregnant women enrolled in the study answered a questionnaire and underwent a physical examination, blood tests, urinalysis, EEG, and visual evoked potential (VEP) and brainstem auditory evoked response (BAER) tests.
An abnormal EEG was found in 5 of the 17 women in the study group (29.4%), whereas none of the 18 women in the control group had an abnormal EEG (p = 0.013). The VEP and BAER tests were normal among the women in both groups. There were no clinically significant differences between the 2 groups with regard to maternal age, gravidity, parity, weeks of gestational age, blood count, renal function, liver function or electrolytes. Low thyroid stimulating hormone levels were found in 6 of the 17 women in the study group (35.3%) as compared to 1 of the 18 in the control group (5.5%) (p = 0.028). None of the women in either group had hyperthyroidism. HG in previous pregnancies was a significant risk factor for HG in the present pregnancy.
In pregnant women with HG during the first trimester, the frequency of abnormal EEG findings is significantly higher as compared to that in pregnant women without NVP. However, the mechanism and implications of these findings are yet to be clarified.
评估一组孕早期患有妊娠剧吐(HG)的其他方面健康的孕妇的中枢神经系统异常情况。
在一项病例对照研究中,将17名孕早期患有HG的孕妇(研究组)与18名孕期无恶心呕吐的孕妇(NVP)进行比较。后一组包括因健康以外原因计划在孕早期终止妊娠的妇女(对照组)。所有纳入研究的孕妇均回答了一份问卷,并接受了体格检查、血液检查、尿液分析、脑电图(EEG)、视觉诱发电位(VEP)和脑干听觉诱发电位(BAER)测试。
研究组17名妇女中有5名(29.4%)脑电图异常,而对照组18名妇女中无一例脑电图异常(p = 0.013)。两组妇女的VEP和BAER测试均正常。两组在产妇年龄、妊娠次数、产次、孕周、血细胞计数、肾功能、肝功能或电解质方面无临床显著差异。研究组17名妇女中有6名(35.3%)促甲状腺激素水平较低,而对照组18名中有1名(5.5%)(p = 0.028)。两组中均无妇女患有甲状腺功能亢进症。既往妊娠有HG是本次妊娠发生HG的一个重要危险因素。
与无NVP的孕妇相比,孕早期患有HG的孕妇脑电图异常发现的频率显著更高。然而,这些发现的机制和意义尚待阐明。