Vomissements incoercibles du premier trimestre de la grossesse : rôle de l’hyperthyroïdie biologique et du sexe fœtal

Abstract

Objectives. Our objectives were to link hyperemesis gravidarum with biochemical hyperthyroidism and hormonal modification (HCG and estradiol) and to test the hypothesis that biological abnormalities (ionogram and liver enzyme) are more often report in hyperemesis gravidarum with biochemical hyperthyroidism. Study design. Thirty three patients admitted in « Hôpital Jeanne de Flandre » with hyperemesis gravidarum were studied prospectively. Results. Twenty-two patients (66.7%) had biochemical hyperthyroïdsm (suppressed thyroid stimulating hormone or increased triiodothyronin index or tetraiodothyronin index). Hyperthyroid patients were more likely than euthyroid patients to have abnormal electrolyte levels (16/22 [72.7%] vs 3/1 [27.3%], P<0.02) or increased liver enzyme levels (8/22 [36.4%] vs 3/11 [27.3%]). The severity of hyperemesis was found to vary directly with the degree of hyperthyroidism. We report a female predominance among the offspring of mothers with hyperemesis gravidarum. Conclusion. Our results are suggestive of the involvement of hyperthyroidism and fetal sex in the pathogenesis of hyperemesis gravidarum. Also these hypothesis are not clearly understood, human chorionic gonadotrophin occur in the two mechanisms.