Recurrence Rate and Risk Factors of Hyperemesis Gravidarum

Hyperemesis gravidarum is the sever extreme of pregnancy related vomiting with relatively low prevalence ranging from 0.3% to 2%. Although the exact etiology remains unclear, several associated risk factors have been identified suggesting multifactorial pathogenesis. The aim of this study is to determine the recurrence rate of hyperemesis gravidarum in those with previous history of hyperemesis gravidarum and to identify which risk factors are predisposing to hyperemesis gravidarum significantly. This is a prospective case- control study done for (7 months). It included (100) gravid women with hyperemesis gravidarum as case group and (130) gravid women without hyperemesis gravidarum, either is first or second trimester admitted to obstetrical ward during same period. The diagnosis of hyperemesis gravidarum based on history and clinical examination. Certain investigations were done to assess the severity. Certain medical illness of gastro-intestinal tract that cause vomiting were excluded. Demographic features of both groups as well as obstetrical and medical history was reviewed through special questionnaire forma. Out of (100) gravid women with hyperemesis gravidarum (71%) were in first trimester. They were of younger age group (i.e. up to 25 years) (63%) and nulliparous (55%) with heavier body weight as (66%) were overweight and obese in term of BMI estimation. The main two obstetrical factors that increase the risk of hyperemesis gravidarum were previous history of hyperemesis gravidarum with recurrence rate of (40%) and positive family history of hyperemesis gravidarum (75%). Motion sickness (52%), GERD disease (43%) and migraine (18%) were significant medical risk factors. Hyperemesis gravidarum mainly affect young age, nulliparous with higher BMI. Previous history of H.G. and positive family history are the most frequent obstetrical risk factors as well as motion sickness, GERD disease, and migraine are the frequent medical risk factors.