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Human Reproduction Update Advance Access published online on July 8, 2005
Human Reproduction Update, doi:10.1093/humupd/dmi021
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received November 3, 2005
Revised May 4, 2005
Accepted May 17, 2005

Article

Hyperemesis gravidarum, a literature review

M.F.G. Verberg 1, D.J. Gillott 2, N. Al-Fardan 3, and J.G. Grudzinskas 4*

1 Academic Unit of Reproductive Physiology, Obstetrics and Gynaecology, St. Bartholomew’s Hospital, West Smithfield, London, UK; Department of Reproductive Medicine, University Medical Center, Utrecht, the Netherlands
2 Academic Unit of Reproductive Physiology, Obstetrics and Gynaecology, St. Bartholomew’s Hospital, West Smithfield, London, UK
3 Department of Health and Medical Services, Obstetric and Gynaecology, Al Wasl Hospital, Dubai, United Arab Emirates
4 Academic Unit of Reproductive Physiology, Obstetrics and Gynaecology, St. Bartholomew’s Hospital, West Smithfield, London, UK; London Bridge Fertility, Gynaecology and Genetics Centre, London, UK

* To whom correspondence should be addressed.
J.G. Grudzinskas, E-mail: ggrudzinkas{at}thebridgecenter.co.uk


  Abstract

Hyperemesis gravidarum (HG) is a condition causing severe nausea and vomiting in early pregnancy often resulting in hospital admission. The incidence of HG is approximately 0.5% of live births, said to be higher in multiple pregnancies, hydatidiform mole and other conditions associated with increased pregnancy hormone levels. Both the aetiology and pathogenesis of HG remain unknown. We conducted a literature review (1966-now) to summarize the current evidence on the aetiology and pathogenesis of HG. The potential role of pregnancy-related hormones such as progesterone, estrogen and HCG has been widely studied; however, various other hormones such as leptin, placental growth hormone, prolactin, thyroid and adrenal cortical hormones have been implicated in the aetiology of HG. In addition to endocrinological hypotheses, the rationale and evidence considering infectious, immunological, psychological, metabolic and anatomical causes for HG have been analysed here. Many studies suffer from the low number of patients included, the variable definition used for HG and varying assay methodology used in studies of hormone measurement. This review highlights the need for more extensive studies addressing the pathogenesis and aetiology of HG.

Keywords: HCG/hyperemesis gravidarum/nausea/pregnancy/vomiting.
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