In theory, increased fluid accumulation resulting from elevated steroid hormones in pregnant women could lead to a pH shift in the gastrointestinal tract, with subclinicalHelicobacter pyloriinfection becoming manifest as a consequence. Hyperemesis gravidarum is relatively frequent in primigravidas with high serum estradiol. This prospective study used anH. pylori–specific fluorescent serum antibody test to find any association betweenH. pyloriinfection and hyperemesis gravidarum. Subjects included 95 pregnant women with hyperemesis gravidarum and 116 unaffected women matched for gestational age.H. pyloriinfection was detected in 91.5 percent of women with hyperemesis gravidarum and in 45 percent of control subjects. The two groups did not differ significantly in age, gravidity, or parity, and there were no substantial differences in preterm births, small-for-gestational-age infants, perinatal deaths, or miscarriages. The hospital stay averaged 5.5 days for women with hyperemesis gravidarum and 1.5 days for control subjects.These findings support the possibility that hyperemesis gravidarum is associated withH. pyloriinfection. It might seem reasonable to eradicateH. pyloriin women with hyperemesis gravidarum to prevent transmitting infection to the fetus, but treating this infection during pregnancy, especially with metronidazole, is problematic.Int J Gynecol Obstet 1999;66:251–254
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