الفهرس 
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Abstract
Nausea and vomiting (morning sickness) occur in almost 70% of all pregnancies, the typical onset is between (5 - 8 weeks) gestation continuing until (14-16 weeks).
Hyperemesis gravidarum is the severe form of emesis gravidarum and usually associated with weight loss (more than 5% of pre-pregnancy weight), dehydration and electrolyte disturbances and may need hospital admission. The reported incidence of hyperemesis gravidarum is about 0.3-2.0%.
Hyperemesis gravidarum can be secondary to other disease processes including appendicitis, pancreatitis, cholecystitis, pyelonephritis and peptic ulcer disease.
The etiology of emesis gravidarum together with its severe form remains unknown. But a number of possible causes have been studied as endocrinal, immunological, psychological, allergic, and gastrointestinal metabolic, genetic and even infectious as helicobacter pylori infection.
Many studies have suggested that there is an association between emesis gravidarum and hyperemesis gravidarum with Helicobacter pylori infection, although it is not the primary cause.
During pregnancy, due to steroid hormone effects, there is an increase in extracellular volume, which leads to a change in pH. Some types of latent Helicobacter pylori infections are sensitive to these changes, and this could lead to the manifestation of Helicobacter pylorus infection. Also, dehydration that is secondary to exchange of extracellular and intracellular fluid causes an increased acidity in the GI tract and hence an increase in the activity of Helicobacter pylorus.
The aim of this study is to find the prevalence Of Helicobacter Pylori infection in pregnant women with hyperemesis gravidarum .
This study included 143 pregnant women with hyperemesis gravidarum at5-18 weeks of gestation. They were recruited from Beni-suef university outpatient clinic.
After approval with consent, All participants will be subjected to:
Full history taking including:
● Personal, past, family and surgical history.
● Previous medical treatment.
● Obstetric history (parity, methods of previous deliveries).
Careful physical examination: to ensure fulfilling both inclusion and exclusion criteria, including general, abdominal and pelvic examination.
Trans-vaginal ultrasonography:The ultrasound equipment used was (Toshiba Xario 200) with 6 - 9 MHz trans-vaginal transducer to ensure date of pregnancy, viability and detect any abnormalities.
Laboratory investigations:
complete blood count, serum electrolytes, liver and kidney function tests, urine analysis, thyroid functions .
Stool antigen test for Helicobacter pylori infection .
Data were collected from all participants as regard maternal age, gestational age, parity and stool antigen test.
All cases were tested for the presence or absence of H. Pylori in stool based on Ig M antibody titre using ELISA method.
Test procedure:
5 ml stool samples were collected, stored at temperature -20ᵒ C and then collectively tested for H. Pylori Ig M using ELISA technique (Abon Biopharm, Co., Ltd, Hangzhou, China).Women were assessed as regards the number of vomiting and a Pregnancy Unique Quantification of Emesis (PUQE-24) scoring was used to quantify the severity of HG at time of admission. PUQE-24 scoring is generated to be specific for vomiting during pregnancy and simpler than the non-specific Rhodes index score (Rhodes et al., 1999; Ebrahimi et al., 2009). The total score is sum of replies to each of the three questions: Mild ≤ 6; Moderate = 7–12; Severe = 13–15 .
We found that the prevalence of H.pylori antigen in stool was 69(48.3%) in the studied participants, 15 patients of them were severe PUQE score .
from that we conclude that Helicobacter pylori has role in the pathogenesis of hyperemesis gravidarum.