Hyperemesis gravidarum pathophysiology: Difference between revisions
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** Peaks at weeks 9-12, which correlates with an increased severity of nausea and vomiting during pregnancy, as well as the symptoms of hyperemesis gravidarum. | ** Peaks at weeks 9-12, which correlates with an increased severity of nausea and vomiting during pregnancy, as well as the symptoms of hyperemesis gravidarum. | ||
** The concentration of hCG in the blood and urine is found to be higher among patients with worsened symptoms of HG.<ref name="pmidhttps://www.ncbi.nlm.nih.gov/pubmed/27209471">{{cite journal| author=Bustos M, Venkataramanan R, Caritis S| title=Nausea and vomiting of pregnancy - What's new? | journal=Auton Neurosci | year= 2017 | volume= 202 | issue= | pages= 62-72 | pmid=https://www.ncbi.nlm.nih.gov/pubmed/27209471 | doi=10.1016/j.autneu.2016.05.002 | pmc=5107351 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27209471 }} </ref> <ref name="pmidhttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc367693">{{cite journal| author=Lawrence WH| title=Phthalate esters: the question of safety. | journal=Clin Toxicol | year= 1978 | volume= 13 | issue= 1 | pages= 89-139 | pmid=http://www.ncbi.nlm.nih.gov/pmc/articles/pmc367693 | doi=10.3109/15563657808988230 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=367693 }} </ref> | ** The concentration of hCG in the blood and urine is found to be higher among patients with worsened symptoms of HG.<ref name="pmidhttps://www.ncbi.nlm.nih.gov/pubmed/27209471">{{cite journal| author=Bustos M, Venkataramanan R, Caritis S| title=Nausea and vomiting of pregnancy - What's new? | journal=Auton Neurosci | year= 2017 | volume= 202 | issue= | pages= 62-72 | pmid=https://www.ncbi.nlm.nih.gov/pubmed/27209471 | doi=10.1016/j.autneu.2016.05.002 | pmc=5107351 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27209471 }} </ref> <ref name="pmidhttp://www.ncbi.nlm.nih.gov/pmc/articles/pmc367693">{{cite journal| author=Lawrence WH| title=Phthalate esters: the question of safety. | journal=Clin Toxicol | year= 1978 | volume= 13 | issue= 1 | pages= 89-139 | pmid=http://www.ncbi.nlm.nih.gov/pmc/articles/pmc367693 | doi=10.3109/15563657808988230 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=367693 }} </ref> | ||
* Gastrointestinal: | |||
** The presence of H pylori in the intestine is found to be commonly associated in women that experience HG. <ref name="pmid23459164">{{cite journal| author=Shaban MM, Kandil HO, Elshafei AH| title=Helicobacter pylori seropositivity in patients with hyperemesis gravidarum. | journal=Am J Med Sci | year= 2014 | volume= 347 | issue= 2 | pages= 101-5 | pmid=23459164 | doi=10.1097/MAJ.0b013e31827bef91 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23459164 }} </ref> | |||
==Genetics== | ==Genetics== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Development of hyperemesis gravidarum is the result from multiple genetic mutations. Hyperemesis gravidarum usually develops during the 2nd trimester of pregnancy.
The pathophysiology of nausea and vomiting during pregnancy is not entirely understood. It is believed to be associated with human chorionic gonadotropin (hCG), a hormone produced by the placenta during pregnancy [5].
Pathogenesis
The pathophysiology of nausea and vomiting during pregnancy is not entirely understood. It is believed to be associated with [human chorionic gonadotropin (hCG)], a hormone produced by the placenta during pregnancy. [1]
According to most studies, it is believed to be multifactorial and related to some genetic, endocrine and gastrointestinal factors.
- Genetic:
- More commonly associated with female monozygotic twins
- Higher risk in patients whose mothers had HG
- Higher risk among patients that had history of HG in their first pregnancy [2]
- Endocrine:
- hCG, estrogen and progesterone are linked to nausea and vomiting in pregnancy [2]
- Patients that experience nausea and vomiting while taking combined oral contraceptive pills are more likely to develop HG in pregnancy. [3]
- Human Chorionic Gonadotropin hormone:
- Gastrointestinal:
- The presence of H pylori in the intestine is found to be commonly associated in women that experience HG. [5]
Genetics
- Hyperemesis gravidarum is transmitted in dominant pattern.
- Gene 1B-alpha2Y is highly associated with hyperemesis gravidarum and twin pregnancies.
Associated Conditions
The most important conditions associated with hyperemesis gravidarum include:
References
- ↑ Herrell HE (2014). "Nausea and vomiting of pregnancy". Am Fam Physician. 89 (12): 965–70. PMID 25162163.
- ↑ 2.0 2.1 2.2 Bustos M, Venkataramanan R, Caritis S (2017). "Nausea and vomiting of pregnancy - What's new?". Auton Neurosci. 202: 62–72. doi:10.1016/j.autneu.2016.05.002. PMC 5107351. PMID https://www.ncbi.nlm.nih.gov/pubmed/27209471 Check
|pmid=value (help). - ↑ Järnfelt-Samsioe A, Samsioe G, Velinder GM (1983). "Nausea and vomiting in pregnancy--a contribution to its epidemiology". Gynecol Obstet Invest. 16 (4): 221–9. doi:10.1159/000299262. PMID 6629143.
- ↑ Lawrence WH (1978). "Phthalate esters: the question of safety". Clin Toxicol. 13 (1): 89–139. doi:10.3109/15563657808988230. PMID http://www.ncbi.nlm.nih.gov/pmc/articles/pmc367693 Check
|pmid=value (help). - ↑ Shaban MM, Kandil HO, Elshafei AH (2014). "Helicobacter pylori seropositivity in patients with hyperemesis gravidarum". Am J Med Sci. 347 (2): 101–5. doi:10.1097/MAJ.0b013e31827bef91. PMID 23459164.