Immunologic and biochemical factors in hyperemesis gravidarum

ABSTRACT

The relationship of Immune process, human chorionic gonadotropin-[beta hCG] and thyroid function in forty pregnant cases of hyperemesi; gravidarum [HG] have been studied. They were divided into two groups Group [I] Control group Ten normal pregnant women and. Group [II] Study group Thirty pregnant women with hyperemesis gravidarum [15 cases diagnosed as hyperthyroxinemic and 15 cases without hyperthyroxinemic]. Serum Beta hCG, immune parameters and thyroid related hormones were assayed in all cases Mean serum Beta hCG, T4 [p< 0.01], IgG, IgM, C3, C4 and lymphocyte count [p < 0.05] were significantly higher in the study than control group. In hyperemesis patients with hyperthyroxinemic, mean serum Beta hCG, IgG,and IgM were significantly higher than in hyperemesis women without hyperthyroxinemic [p < 0.01]. Beta hCG was positively correlated with T4 [r =0.31], lymphocyte count [r =0.36], IgG [r=0.70], IgM [r = 0.67] and with C4 [r = 0.39] in hyperemesis patients. A negative correlation between Beta hCG and TSH [r = -0.80 p < 0.01] was noted in hyperemesis group Free T4 showed a positive association to IgM, IgG and lymphocyte count. Immunologic activity in pregnancy may have a role on the stimulatory mechanism of Beta hCG in hyperemesis patients. The relationship between T4 and immunoglobulins in HG may be indirect and may be dependent on high levels of serum Beta hCG with higher thyrotropic activity