THE ROLE OF HELICOBACTER PYLORI IN PATHOGENESIS OF HYPEREMESIS GRAVIDARUM

OBJECTIVE To evaluate the role of Helicobacter pylori in the pathogenesis of HG and the value of adding a non-teratogenic regimen for its treatment in intractable cases. PATIENTS & METHODS Sixty pregnant women with hyperemesis gravidarum (HG) were matched with 60 control pregnant women with no history of HG. The study was conducted at Basrah Maternity and Child Hospital. A full history was obtained including medical disorder and drug usage. Serum H.pyloriIgG antibody titres were estimated by using commercial ELIZA method for all patients and control. The pregnant women with positive H.pylori test were subdivided into 2 groups for the purpose of treatment. The first group was received traditional treatment of HG which include I/V fluid, antiemetic, antacid and vitamin supplement. The second group was received H.pylori treatment include proton pump inhibitor, amoxicillin and metronidazole. Then, both groups were followed up for the number of vomiting, duration of hospitalization and pregnancy outcome. RESULTS Fifty three out of 60 women with HG were seropositive for H.pylori(85%) and 34 out of 60 control group were seropositive (55%). It is highly significant in regard to primigravida and level of education between the seropositive and seronegative in the studied group. There is significant clinical improvement in patients who received H.pylori regimen than the group who received traditional therapy regard duration of admission to hospital and decrease number and frequency of vomiting in the studied group. CONCLUSIONS Helicobacter pylori should be considered as one of the causes of HG and screening for it should be added for investigation. H.pyloriregimen may be considered in intractable cases