الفهرس 
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Abstract
Nausea and vomiting are a common occurrence during early pregnancy with pregnant females complaining of this complication in more than 80% of all pregnancies. A much smaller group (up to 2% of all pregnancies) suffers from hyperemesis gravidarum (HEG), a condition characterized by intractable vomiting.
Hyperemesis gravidarum can be associated with substantial morbidity, including fluid and electrolytes imbalance, weight loss and nutritional deficiency. Rarely, severer complication might occur, including Wernicke’s encephalopathy, liver or renal insufficiency.
The etiology of HEG is not well understood. Elevated levels of steroid hormones were incriminated as a causative agent of this clinical condition. As a result of increased fluid accumulation, which results from the elevated level of steroid hormones, a change of pH can occur. This change of pH, which also occurs in gastrointestinal tract, could result in the manifestation of subclinical Helicobacter pylori infection.
The aim of this work was to study the relation between Helicobacter pylori infection and the occurrence of hyperemesis gravidarum.
The study was conducted on eighty pregnant females with the age ranging between 20-35 years, with singleton pregnancies of gestational age ranging between 7-16 weeks. The cases were divided into two groups:
group I: (cases [study] group): including 40 females presenting with HEG (as diagnosed by vomiting more than three times daily, weight loss and ketonuria).
group II: (control group): including 40 normal pregnant females with the same inclusion criteria.
Patients with history of gastric problems or vomiting not related to pregnancy were excluded from the study. Also, those with suspected conditions, which may be associated with vomiting, whether medical (as diabetes mellitus), surgical (as appendicitis), obstetrical (as twisted ovarian cyst, multiple pregnancy, trophoblastic diseases), psychological or neurological diseases (as causes of increased intracranial tension).
Cases and controls were subjected to the following:
1. Thorough history taking.
2. Complete general and obstetrical examination.
3. Complet urine analysis.
4. Complet blood picture (CBC).
5. Fasting blood sugar (FBS).
6. SGOT, SGPT.
7. Urea, createnine.
8. Pelvic ultrasonography: to exclude multiple pregnancy, trophoblastic diseases, twisted ovarian cysts.
9. Venous blood sample to detect IgG antibodies for Helicobacter pylori (by ELISA technique).
10. Stool samples to detect Helicobacter pylori antigen.
Results obtained showed the following
There were no statistical significant differences between the two study groups regarding gravidity parity and abortion.
There were statistical significant differences between two study groups regarding weight that ranged between 42-74Kg and 57-83Kg with mean of 60.40±10.45 and 71.70±7.88 for group 1 and 2 respectively.
There were statistical significant differences between two study groups regarding systolic blood pressure that ranged between 80-100 and 100-130 with mean of 89.13±6.97 and 116.0±10.01 for group 1 and2 respectively, diastolic blood pressure that ranged between 50-70 and70-80 with mean of 60.75±7.81 and 75.0±4.53 for group1 and2 respectively, and pulse that ranged between 75-96 and71-84 with mean of 86.45±7.32 and 76.52±3.19 for group 1and 2 respectively.
Helicobacter pylori antibodies in blood samples were positive in 31 of 40 cases with77.5% and 22 of 40 controls with 55%. These results were touching statistical significant differences between two groups with p=0.058.
Helicobacter pylori antigens in stool samples were positive in 30 of 40 cases with75% and 15 of 40 controls with 37.50%. These results were statistical significant differences between two groups with p=0.001.