BACKGROUND: Nausea and vomiting associated with pregnancy commonly occurs in 80% of all pregnancies. They begin usually at 9th-10th weeks of gestation, reaching the beak at 11th – 13th weeks and disappear at 16th – 18th weeks. Its severity varies from mild (not affecting general condition of the patients) to severe (causing intractable vomiting, electrolyte imbalance, weight loss >5%, impairment of liver and kidney functions and dehydration). It may cause even maternal and fetal deaths. Hyperemesis gravidarum (HG) is defined as persistent and excessive vomiting starting before the end of the 22nd week of gestation. HG affects approximately 0.3%–2.0% of pregnancies. 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.
OBJECTIVE: Assessing the seopositivity for helicobacter pylori IgG in hyperemesis gravidarum patients versus normal pregnant women.
SUBJECT AND METHODS: A case control study was done on 100 pregnant women, divided into two equal groups; Group (I): Pregnant women complaining of hyperemesis gravidarum, while Group (II): Normal pregnant women. Both groups underwent routine clinical and laboratory examination, and H. Pylori infection assessment by qualitative and quantitative determination of H. pylori IgG in serum by ELISA.
RESULTS: There was no significant difference between both groups as regards age or gestational age. No significant association between groups and H. Pylori IgG Seropositivity. The IgG antibody titers was higher in pregnant women with emesis gravidarum than in normal pregnant “control" women. The cutoff point for IgG titer in pregnant women with HG was 34 AU/ml. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 82%, 97.9%, 97.6%, 83.6% and 89.6% respectively.
CONCLUSION: There was a significant correlation between Helicobacter pylori infection and occurrence of emesis gravidarum. It is recommended to add Helicobacter pylori serum IgG as a screening test to the investigations for all women who are complaining of emesis gravidarum.