Role of Helicobacter pylori in the pathogenesis of hyperemesis gravidarum

Arch Gynecol Obstet. 2011 Oct;284(4):843-7. doi: 10.1007/s00404-010-1759-8. Epub 2010 Nov 16.


Purpose: 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.

Conclusion: Screening for H. pylori should be added to the investigations of hyperemesis gravidarum cases. Non teratogenic treatment can be considered in intractable cases.

MeSH terms

  • Adult
  • Ampicillin / administration & dosage
  • Anti-Infective Agents / administration & dosage
  • Anti-Ulcer Agents / administration & dosage
  • Antibodies, Bacterial / analysis
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gastroscopy
  • Helicobacter Infections / diagnostic imaging
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / microbiology*
  • Helicobacter Infections / pathology
  • Helicobacter pylori / immunology
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Hyperemesis Gravidarum / diagnostic imaging
  • Hyperemesis Gravidarum / drug therapy
  • Hyperemesis Gravidarum / microbiology*
  • Hyperemesis Gravidarum / pathology
  • Metronidazole / administration & dosage
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnostic imaging
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy Complications, Infectious / pathology
  • Pregnancy Trimester, First
  • Prenatal Care
  • Prenatal Diagnosis
  • Prospective Studies
  • Ranitidine / administration & dosage
  • Treatment Outcome
  • Ultrasonography


  • Anti-Infective Agents
  • Anti-Ulcer Agents
  • Antibodies, Bacterial
  • Metronidazole
  • Ampicillin
  • Ranitidine