الفهرس 
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Abstract
Vomiting (morning sickness) occur in almost 70% of all pregnancies, the typical onset is between 5 and 8 weeks gestation continuing until 14-16 weeks. Severe nausea and vomiting associated with weight loss, dehydration and electrolyte disturbance is called hyperemesis gravidarum(HG). It complicates 0.3-2% of all pregnancies, the cause of HG which still remains unknown seems to be multifactorial.
Recently several studies have implicated H. pylori infection as a possible cause for HG. There is an increasing importance of treatment of H. pylori and a great need for simple, accurate, inexpensive and noninvasive diagnostic methods. The aim of our study is to determine if there is an association between Helicobacter pylori infection and hyperemesis gravidarum.
In this study, there were 50 patients diagnosed as having hyperemesis gravidarum and hospitalized at Benha University Hospitals.
All patients included in this study (50 cases) were consented, admitted to the ward and were isolated from other patients.
All patients who admitted with hyperemesis gravidarum were underwent full history taking, general and abdominal examination, laboratory investigations (CBC, coagulation profile, liver and kidney function tests and urine analysis), ABG, serum electrolytes, serum H. pylori IgG antibody titer and stool sample was taken to detect H. Pylori antigen, as well as ultrasound , in order to exclude any other obstetric cause for hyperemesis such as multiple pregnancy or molar pregnancy.
The results showed the following:
The participant’s age ranged between 17 and 32 years with mean of 22 years old. The mean gestational age was 10.6 weeks, almost half of the participants were primigravida (52%) and 68% were nulliparous, three forth of participants (76%) had no previous history of abortion; however, 12% of them had history of abortion for single time.
About 67 % of the multigravida had a history of previous hyperemesis gravidarum, almost half of participants was of severe degree (48%) and 36% showed moderate degree.
In our study 72% of the studied participant’s experienced positive H. pylori antibodies and 56% of patients had H. pylori antigens in stool.
The mean potassium level of the women with seropositive was 3.03 mEq/L, the mean sodium level with seropositive women was 128.2 mEq/L, ketonuria in seropositive women was 80.6%, as regarding liver enzymes, AST was found to be elevated in 75% in seropositive women, ALT was found to be elevated in 72.2% in seropositive women.
About 64.3% of those found with positive H. pylori antigens showed severe hyperemesis gravidarum and only 14.3% showed mild degree.
Conclusion
There was a strong association between H. pylori infection and hyperemesis gravidarum.
Recommendations
• Searching for Helicobacter pylori infection must be added to the investigations of pregnant women with refractory prolonged hyperemesis gravidarum especially if resistant to antiemetic drugs, the management of H. Pylori included combination therapy of amoxicillin (1 gm twice daily for 7-14 days); metronidazole (500 mg twice daily for 7-14 days) and proton pump inhibitor (PPI) twice daily for 7-14days.