Rech F, Lojodice S, Indraccolo S R
Scuola Autonoma di Ostetricia Camerino (Macerata), Università degli Studi di Roma La Sapienza, Roma.
Minerva Ginecol. 1998 Jun;50(6):261-4.
A possible association of hyperemesis gravidarum with biochemical transient hyperthyroidism (a significant self-limited increase in serum levels of some thyroid hormones) has long been reported. It seems there is not any causal connection between the two above mentioned conditions, but they may be both independently related to the same cause: the trophoblastic production of a large amount of human chorionic gonadotropin or, otherwise, the presence in the maternal circulation of structural variants of hCG with higher biological activity. The validity of such hypothesis, denied by some authors, encounters the verification in the peculiar clinical case described in this report. It also shows clearly the danger of considering a case of hyperemesis gravidarum as of psychological nature, without having preliminarily excluded an organic cause. For the pregnant woman, to hear of her unconscious refusal of pregnancy or of the timeliness of her removal from the environment in which some conflictual situations have likely raised or, furthermore, to hear of other common places often too easily evoked could be cause of anxiety and unjustified feelings of guilt.
妊娠剧吐与生化性短暂甲状腺功能亢进（某些甲状腺激素血清水平显著的自限性升高）之间可能存在关联，这一情况早已被报道。上述两种情况之间似乎不存在因果联系，但它们可能都独立地与同一原因相关：滋养层产生大量人绒毛膜促性腺激素，或者母血循环中存在生物活性更高的人绒毛膜促性腺激素结构变体。一些作者否认了这一假设的有效性，而本报告中描述的特殊临床病例对其进行了验证。这也清楚地表明，在未预先排除器质性病因的情况下，将妊娠剧吐病例视为心理性病例的危险性。对于孕妇而言，听到自己无意识地拒绝怀孕，或者听到自己及时离开了可能引发一些冲突情况的环境，或者听到其他常常轻易被提及的陈词滥调，都可能成为焦虑和无端内疚感的原因。
