[Hyperemesis in the first trimester of pregnancy: role of biological hyperthyroidism and fetal sex].
OBJECTIVE
Our objectives were to link hyperemesis gravidarum with biochemical hyperthyroidism and hormonal modification (HCG and estradiol) and to test the hypothesis that biological abnormalities (ionogram and liver enzyme) are more often reported in hyperemesis gravidarum with biochemical hyperthyroidism.


METHODS
Thirty three patients admitted in "Hôpital Jeanne de Flandre" with hyperemesis gravidarum were studied prospectively.


RESULTS
Twenty-two patients (66.7%) had biochemical hyperthyroïdsm (suppressed thyroid stimulating hormone or increased triiodothyronine index or tetraiodothyronine index). Hyperthyroid patients were more likely than euthyroid patients to have abnormal electrolyte levels (16/22 [72.7%] vs 3/1 [27.3%], P < 0.02) or increased liver enzyme levels (8/22 [36.4%] vs 3/11 [27.3%]). The severity of hyperemesis was found to vary directly with the degree of hyperthyroidism. We report a female predominance among the offspring of mothers with hyperemesis gravidarum.


CONCLUSIONS
Our results are suggestive of the involvement of hyperthyroidism and fetal sex in the pathogenesis of hyperemesis gravidarum. Also these hypothesis are not clearly understood, human chorionic gonadotrophin occurred in the two mechanisms.
Deruelle
P
P
Clinique de gynécologie, obstétrique et néonatologie, hôpital Jeanne-de-Flandre, CHRU Lille, 1, rue Eugène-Avinée, 59037 Lille, France. pderuelle@free.fr
Dufour
P
P
Subtil
D
D
Houfflin-Debarge
V
V
Dherbomez
A
A
Wemeau
J L
JL
Puech
F
F
D000328:Adult; D004573:Electrolytes / Q000097:blood; D005260:Female; D005333:Fetus; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000209:etiology*; D006980:Hyperthyroidism / Q000150:complications* / Q000503:physiopathology; D008099:Liver / Q000201:enzymology* / Q000503:physiopathology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012737:Sex Factors
D004573:Electrolytes