Department of Obstetrics and Gynecology, Ain Shams University, 5th El Gahez street, Seventh area, Nasr city, Cairo, Egypt.
Arch Gynecol Obstet. 2011 Oct;284(4):843-7. doi: 10.1007/s00404-010-1759-8. Epub 2010 Nov 16.
To evaluate the role of Helicobacter pylori (H. pylori) in the pathogenesis of hyperemesis gravidarum (HG) and the value of adding a non teratogenic regimen for its treatment in intractable cases.
Eighty hyperemesis gravidarum cases were recruited from Ain Shams University out patient clinics. A complete history was taken including history of medical disorders and chronic medications intake as non steroidal anti-inflammatory drugs. After general and local examination, ultrasound was done for all cases to exclude obstetric causes of hyperemesis. Eighty normal pregnant women acted as control. Serum test for H. pylori IgG antibody titre was done for all patients and controls.
Seventy-one cases among the 80 HG cases and twenty-four out of the 80 controls were H. pylori positive. Eight HG cases developed severe intractable vomiting. Three of them developed attacks of hematemesis. Gastroscopy done for the eight cases revealed antral gastritis and duodenitis. Gastric and duodenal erosions were found in two cases. The eight patients received a non teratogenic regimen for treatment. Attacks of vomiting decreased and pregnancy continued till delivery of healthy newborns.
Screening for H. pylori should be added to the investigations of hyperemesis gravidarum cases. Non teratogenic treatment can be considered in intractable cases.
评估幽门螺杆菌（H. pylori）在妊娠剧吐（HG）发病机制中的作用，以及在难治性病例中添加非致畸治疗方案的价值。
从艾因夏姆斯大学门诊招募了 80 例妊娠剧吐病例。采集完整病史，包括既往疾病史和慢性药物（如非甾体抗炎药）摄入史。进行全面和局部检查后，对所有病例进行超声检查以排除妊娠剧吐的产科原因。80 例正常孕妇作为对照组。对所有患者和对照组进行血清 H. pylori IgG 抗体滴度检测。
80 例 HG 病例中有 71 例和 80 例对照中有 24 例 H. pylori 阳性。8 例 HG 病例出现严重难治性呕吐。其中 3 例出现呕血发作。对 8 例患者进行胃镜检查显示胃窦炎和十二指肠炎。2 例发现胃和十二指肠糜烂。这 8 例患者接受了非致畸治疗方案。呕吐发作减少，妊娠继续至健康新生儿分娩。
应将 H. pylori 筛查添加到妊娠剧吐病例的检查中。在难治性病例中可以考虑非致畸治疗。
