Endothelial Dysfunction in Hyperemesis Gravidarum
Endothelial Dysfunction in Hyperemesis Gravidarum
The purpose of the study is to determine serum inflammatory adhesion molecules levels in
 hyperemesis gravidarum
The study population consisted of 2 groups; (1) the hyperemesis gravidarum group, consist of
 25 pregnant women who developed dehydration due to HG between 6 and 13 gestational weeks and
 between 18 and 35 years (2) the normal pregnancy group, consisting of 25 pregnant women.

 HG was defined according to the fallowing American College of Obstetricians and Gynecologists
 (ACOG) criteria; severe nausea and vomiting resulted in 5% weight loss with regard to
 pre-gestation or vomiting more than 3 times and 3-5 % weight loss with ketonuria. The
 diagnosis of dehydration was clinically defined and patients with moderate and severe
 dehydration were included in the study. As clinical findings; Weight loss, capillary recall
 time, dry mucous membranes, dry eye, pulse rate, systolic blood pressure, respiration, skin
 turgor deterioration and urine output were evaluated.

 Other pathologies causing nausea and vomiting like; gastroenteritis, gastroparesis, gall duct
 diseases, hepatitis, peptic ulcers, appendicitis, pyelonephritis, ovarian torsion, urinary
 tract stones, diabetic ketoacidosis, hyperthyroidism, hyperparathyroidism, migraine, pseudo
 tumor cerebra, vestibular diseases were excluded from the study.Patients were excluded from
 the study in the presence of pregestational diabetes chronic hypertension, chronic liver and
 renal failure, preeclampsia history, multiple pregnancy, hyperlipidemia,
 hypercholesterolemia, obesity, tobacco use, NSAID drug use, infection within the last three
 months and surgery within the last month that could cause endothelial dysfunction.

 Blood and urine specimens were collected from the patients with HG during hospitalization and
 during regular clinic visits in control group. The 2mL of blood samples were withdrawn into
 serum-separating tubes for the measurements of serum biochemical parameters and 2 mL blood
 samples were withdrawn into EDTA containing tubes for measurement serum hemoglobin and
 hematocrit levels. Early-morning urine samples were collected from study population. These
 blood and urine samples were analyzed in same day for Kayseri Education and Research hospital
 biochemical clinics. In addition 2mL of blood samples were withdrawn into serum-separating
 tubes for analyzing serum sVEGFR-1, sVCAM-1, sE-selectin and sICAM-1 levels. All of the serum
 were stored at -80°C in nonadsorbable tubes. After three months for stored first blood
 sample, serum sVEGFR-1, sVCAM-1, sE-selectin and sICAM-1 levels were determined by an enzyme
 linked immunosorbent assay.
Inclusion Criteria:

 -  6-13 gestational weeks

 -  between 18-35 years of age

 -  Single pregnancy

 -  Dehydration due to HG

 Exclusion Criteria:

 Other pathologies causing nausea and vomiting;

 -  gastroenteritis

 -  gastroparesis

 -  gall duct diseases

 -  hepatitis

 -  peptic ulcers

 -  appendicitis

 -  pyelonephritis

 -  urinary tract stones

 -  hyperthyroidism

 -  hyperparathyroidism

 -  migraine

 -  vestibular diseases

 Patients were excluded from the study in the presence of parameters that may cause
 endothelial dysfunction such as;

 -  pregestational diabetes

 -  chronic hypertension

 -  chronic liver and renal failure

 -  preeclampsia history

 -  multiple pregnancy

 -  hyperlipidemia

 -  hypercholesterolemia

 -  obesity

 -  tobacco use

 -  NSAID drug use

 -  infection within the last three months

 -  surgery within the last month