title: Role of Helicobacter pylori in the pathogenesis of hyperemesis gravidarum.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Screening for H. pylori should be added to the investigations of hyperemesis gravidarum cases. Non teratogenic treatment can be considered in intractable cases.
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, 5th El Gahez street, Seventh area, Nasr city, Cairo, Egypt. gmansour@hotmail.com
authors.forename: Ghada M
authors.initials: GM
authors.lastname: Mansour
authors.forename: Ehab H
authors.initials: EH
authors.lastname: Nashaat
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D000907:Antibodies, Bacterial / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D008795:Metronidazole / Q000008:administration & dosage; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D011261:Pregnancy Trimester, First; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D011899:Ranitidine / Q000008:administration & dosage; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D000907:Antibodies, Bacterial; D008795:Metronidazole; D000667:Ampicillin; D011899:Ranitidine