title: Autonomic and Enteric Nervous System Dysfunction May Play a Role in Hyperemesis Gravidarum.
abstract: BACKGROUND
  Nausea and vomiting, seen in 70-85% of all pregnancies, becomes intractable in hyperemesis gravidarum (HG). We aimed to investigate the relationship between HG and autonomic nervous system functioning and gastric electrical activity.
  
  
  METHODS
  Twenty-seven pregnant patients, 21 with HG and six normal, were studied with sympathetic adrenergic; percent vasoconstriction (%VC) and postural adjustment ratio (PAR); parasympathetic vagal cholinergic functions by R-to-R intervals (RRIs), a total autonomic score; and enteric nervous system measured by electrogastrography (EGG).
  
  
  RESULTS
  Significant differences were found in parasympathetic measures (RRI for HG 29.98 ± 2.95 vs. control 40.91 ± 2.38, P < 0.05); sympathetic PAR was significantly lower in patients (PAR for HG 24.5 ± 5.0 vs. 67.6 ± 11.4 for controls, P < 0.01); mean total autonomic score was significantly lower in HG (131.75 ± 9.61 vs. 196.87 ± 12.8, P < 0.05). EGG results were borderline different (normal < 3.3, HG 3.4 vs. controls 3.0, P = 0.07).
  
  
  CONCLUSIONS
  Autonomic and enteric nervous system dysfunction may play a role in the pathophysiology of HG.
authors: Mayo Clinic, Rochester, MN, USA.
authors: Joy D
authors: JD
authors: Hughes
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Neeta G
authors: NG
authors: Nayak
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Naeem
authors: N
authors: Aslam
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Hani
authors: H
authors: Rashed
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Sergio
authors: S
authors: Cardoso
authors: Department of Electrical Engineering, University of Memphis, Memphis, TN, USA.
authors: Babajide
authors: B
authors: Familoni
authors: Department of Electrical Engineering, University of Memphis, Memphis, TN, USA.
authors: James G
authors: JG
authors: Karas
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: David C
authors: DC
authors: Shaver
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Robert S
authors: RS
authors: Egerman
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Alan
authors: A
authors: Wallstedt
authors: Departments of Internal Medicine (Gastroenterology Division) and Obstetrics/Gynecology, and the Autonomic Function Lab, University of Tennessee Bowld Hospital, The University of Tennessee, Memphis, TN, USA.
authors: Caroline A
authors: CA
authors: Riely
authors: Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA.
authors: Thomas L
authors: TL
authors: Abell
keywords: Autonomic nervous system; Enteric nervous system; Hyperemesis gravidarum; Nausea and vomiting; Pregnancy; Weight loss