Double marker test and uterine Doppler in cases with hyperemesis gravidarum

Abstract

Background Hyperemesis gravidarum is defined as excessive nausea and vomiting with pregnancy, unrelated to intake of food and to causes other than pregnancy, that leads to dehydration and/or loss of 5% prepregnancy weight. In addition to the clinical symptoms, chemical laboratory tests and urinary status are pointers. Pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (β-hCG) are two maternal serum markers currently used for screening between 10 and 14 weeks of gestation. No adverse obstetrical outcomes have been described with elevated PAPP-A levels during the first trimester. Doppler ultrasound investigation of the uterine arteries is a reliable, noninvasive method for assessing the extent of trophoblastic invasion. The uteroplacental circulation can be assessed with Doppler ultrasonography of the uterine arteries. Aim This study was conducted to evaluate the possible relationship between double marker test (serum β-hCG, PAPP-A) and uterine artery Doppler indices in cases with hyperemesis gravidarum at 11–13 weeks of gestation in 60 patients admitted to El-Shatby Maternity University Hospital. Patients and methods Patients were divided into two groups: the study group included those diagnosed with hyperemesis gravidarum and the control group included those with normal uncomplicated first trimester pregnancy. Our study concluded that testing for serum levels of β-hCG and PAPP-A in cases of hyperemesis gravidarum showed insignificant difference compared with normal gestation cases and is not recommended for routine clinical practice. Results and conclusion Our study also concluded that Doppler indices for blood flow in uterine arteries showed insignificant difference between cases of hyperemesis gravidarum and normal gestation cases, thereby signifying that hyperemesis gravidarum is not a risk factor for the development of preeclampsia or intrauterine growth restriction later during pregnancy.