Shaban, M. M., Kandil, H. O., & Elshafei, A. H. (2014). Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. The American journal of the medical sciences, 347(2), 101-105. https://doi.org/10.1097/MAJ.0b013e31827bef91
Shaban MM, Kandil HO, Elshafei AH. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. Am J Med Sci. 2014;347(2):101-105. doi:10.1097/MAJ.0b013e31827bef91
Shaban, Mona M., et al. "Helicobacter pylori seropositivity in patients with hyperemesis gravidarum." The American journal of the medical sciences, vol. 347, no. 2, 2014, pp. 101-105.
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Departments of Obstetrics and Gynecology (MMS, HOK, AHE), and Community Medicine (MMS, HOK, AHE), Faculty of Medicine, Cairo University, Cairo, Egypt.
Nausea and vomiting during pregnancy are the most common conditions affecting pregnancy, occurring in about 80% of all pregnancies and always disappearing on the 16th to 18th weeks of gestation. This may be mild and it does not affect the general condition of the patient (the condition is called emesis gravidarum), or it may be severe enough to affect the patient physically and psychologically, causing intractable vomiting, electrolyte imbalance, weight loss >5%, impairment of liver and kidney functions and dehydration. Helicobacter pylori is one of the most common bacterium affecting humans. It is a gram-negative helix-shaped microaerophilic bacterium transmitted by the oro-oral or feco-oral route. It is more prevalent in developing countries and affects young children. Acute infection manifests as acute gastritis and stomach pain, whereas chronic infection causes chronic gastritis and peptic ulcer, 2% of which may develop into stomach cancer. The authors tried to investigate the association between H pylori infection and hyperemesis gravidarum.
Methods
Fifty patients with hyperemesis gravidarum and 50 patients with normal pregnancy were included in the study. H pylori infection was determined using a 1-step H pylori test device (serum/plasma), which is a qualitative membrane-based immunoassay.
Results
Regarding maternal age, gestational age and socioeconomic status, there is no statistical difference between both groups. There is a marked statistical difference between both groups in terms of Helicobacter pylori seropositivity and frequency of vomiting.
Conclusions
There is a powerful correlation between H pylori and hyperemesis gravidarum.
Li L et al., 2015·Gastroenterol Res Pract·Free full text on PubMed Central
Background. Several studies have shown a possible involvement of Helicobacter pylori (H. pylori) infection in individuals with hyperemesis gravidarum (HG), but the relationship remains controversial. This meta-analysis was performed to validate and strengthen the association between HG and H. pylori infection. Methods. PubMed, Embase, and Web of Science databases up to March 20, 2014, were searched to select studies on the prevalence of H. pylori infection between pregnant women with HG and the normal pregnant control subjects. Results. Of the HG cases, 1289 (69.6%) were H. pylori-positive; however, 1045 (46.2%) were H. pylori-positive in control group. Compared to the non-HG normal pregnant controls, infection rate of H. pylori was significantly higher in pregnant women with HG (OR = 3.34, 95% CI: 2.32-4.81, P < 0.001). Subgroup analysis indicated that H. pylori infection was a risk factor of HG in Asia, Africa, and Oceania, especially in Africa (OR = 12.38, 95% CI: 7.12-21.54, P < 0.001). Conclusions. H. pylori should be considered one of the risk factors of HG, especially in the developing countries. H. pylori eradication could be considered to relieve the symptoms of HG in some intractable cases.
Prescribing Safety · Medication Safety in Pregnancy
Fejzo MS et al., 2019·Nature reviews. Disease primers
Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for hyperemesis gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3-10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7) and hormone receptors (namely GFRAL and PGR). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG.
Nijsten K et al., 2021·Acta obstetricia et gynecologica Scandinavica·Free full text on PubMed Central
Hyperemesis gravidarum (HG) complicates 1% of pregnancies and has a major impact on maternal quality of life and well-being. We know very little about HG's long-term impact after an affected pregnancy, including recurrence rates in future pregnancies, which is essential information for women considering subsequent pregnancies. In this study, we aimed to prospectively measure the recurrence rate of HG and the number of postponed and terminated subsequent pregnancies due to HG. We also aimed to evaluate if there were predictive factors that could identify women at increased risk for HG recurrence, and postponing and terminating subsequent pregnancies. We conducted a prospective cohort study. A total of 215 women admitted for HG to public hospitals in the Netherlands were enrolled in the original MOTHER randomized controlled trial and associated observational cohort. Seventy-three women were included in this follow-up study. Data were collected through an online questionnaire. Recurrent HG was defined as vomiting symptoms accompanied by any of the following: multiple medication use, weight loss, admission, tube feeding or if nausea and vomiting symptoms were severe enough to affect life and/or work. Outcome measures were recurrence, postponing, and termination rates due to HG. Univariable logistic regression analysis was used to identify predictive factors associated with HG recurrence, and postponing and terminating subsequent pregnancies. Thirty-five women (48%) became pregnant again of whom 40% had postponed their pregnancy due to HG. HG recurred in 89% of pregnancies. One woman terminated and eight women (23%) considered terminating their pregnancy because of recurrent HG. Twenty-four out of 38 women did not get pregnant again because of HG in the past. Univariable logistic regression analysis identifying possible predictive factors found that having a western background was associated with having weight loss due to recurrent HG in subsequent pregnancies (odds ratio 12.9, 95% CI 1.3-130.5, p = 0.03). High rates of HG recurrence and a high number of postponed pregnancies due to HG were observed. Women can be informed of a high chance of recurrence to enable informed family planning.
Fejzo MS et al., 2018·Nature communications·Free full text on PubMed Central
Hyperemesis gravidarum (HG), severe nausea and vomiting of pregnancy, occurs in 0.3-2% of pregnancies and is associated with maternal and fetal morbidity. The cause of HG remains unknown, but familial aggregation and results of twin studies suggest that understanding the genetic contribution is essential for comprehending the disease etiology. Here, we conduct a genome-wide association study (GWAS) for binary (HG) and ordinal (severity of nausea and vomiting) phenotypes of pregnancy complications. Two loci, chr19p13.11 and chr4q12, are genome-wide significant (p < 5 × 10-8) in both association scans and are replicated in an independent cohort. The genes implicated at these two loci are GDF15 and IGFBP7 respectively, both known to be involved in placentation, appetite, and cachexia. While proving the casual roles of GDF15 and IGFBP7 in nausea and vomiting of pregnancy requires further study, this GWAS provides insights into the genetic risk factors contributing to the disease.
General Gynecology › Infections › Vaginal and Cervical Infections
Mona M Shaban, Arwa H Elshafei, Hisham O Kandil
M Shaban, A Elshafei, H Kandil
PMID 23459164 23459164 DOI 10.1097/MAJ.0b013e31827bef91 10.1097/MAJ.0b013e31827bef91 Shaban et al. 2013, Shaban 2013
Cite this article
Shaban, M. M., Kandil, H. O., & Elshafei, A. H. (2014). Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. The American journal of the medical sciences, 347(2), 101-105. https://doi.org/10.1097/MAJ.0b013e31827bef91
Shaban MM, Kandil HO, Elshafei AH. Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. Am J Med Sci. 2014;347(2):101-105. doi:10.1097/MAJ.0b013e31827bef91
Shaban, Mona M., et al. "Helicobacter pylori seropositivity in patients with hyperemesis gravidarum." The American journal of the medical sciences, vol. 347, no. 2, 2014, pp. 101-105.
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