KORYON FRONDOSUM KALINLIĞI İLE CİDDİ HİPEREMEZİS GRAVIDARUM ARASINDA BİR İLİŞKİ VAR MIDIR?

Yıl 2025, Cilt: 6 Sayı: 2, 111 - 116, 20.05.2025

Sabahattin Anıl Arı , İbrahim Karaca , Çağdaş Şahin

https://doi.org/10.47482/acmr.1608827

Öz

Amaç: Hiperemesis gravidarum (HG), şiddetli mide bulantısı, kusma, kilo kaybı ve dehidratasyonla karakterize bir gebelik komplikasyonudur. Mevcut çalışma, koryon frondozum (KF) kalınlığını ve plasenta disfonksiyonu ile hiperemesis gravidarum arasındaki ilişkiyi araştırmak amacıyla yapılmıştır.
Yöntem: Bu çalışmaya, gebeliğin ilk üç ayında 96 katılımcıyı dahil edildi. 48 olgunun hiperemesis gravidarum semptomları ve +2/+3 idrar keton seviyeleri olduğu saptandı. Diğer okatılımcılar kontrol grubuna dahil edildi. Demografik özellikler, kan β-hCG, tiroid hormon seviyeleri (TSH, fT3, fT4), aspartat aminotransferaz (AST), alanin aminotransferaz (ALT) ve idrar keton seviyeleri tüm katılımcılardan elde edildi. KF kalınlığı ile HG arasındaki ilişkiyi göstermek için her katılımcının KF kalınlığı ölçüldü.
Bulgular: HG grubunda ortalama gebelik yaşı 8,69 (± 2,15) hafta ve kontrol grubunda 8,92 (± 2,14) hafta idi (p=0,6). HG grubunda idrar keton seviyeleri (+2,7) kontrol grubuna (+0,1) kıyasla anlamlı derecede daha yüksekti (p<0,001). CF kalınlığı HG grubunda (16,02 mm) kontrol grubuna (13,50 mm) kıyasla anlamlı derecede daha yüksekti (p=0,02).
Sonuç: Ortalama koryon frondozum kalınlığı (KF), HG grubunda sağlıklı kontrollere kıyasla anlamlı derecede daha yüksek bulunmuştur. Bu bulgu, patofizyolojiyi göstermenin yanı sıra klinik bir öngörü de oluşturabilir.

Anahtar Kelimeler

koryon , hiperemezis gravidarum , ultrasonografi

IS THERE A RELATION BETWEEN CHORION FRONDOSUM THICKNESS AND SEVERE HYPEREMESIS GRAVIDARUM?

Öz

Background: Hyperemesis gravidarum (HG) is a pregnancy complication that is characterized by severe nausea, vomiting, weight loss, and dehydration. The current study investigated chorion frondosum (CF) thickness and the relation between placental dysfunction and hyperemesis gravidarum.
Methods: We enrolled 96 participants in this study during their first trimester of pregnancy. We found that 48 of them had hyperemesis gravidarum symptoms and +2/+3 urine ketone levels. The others were taken as controls. Demographic characteristics, blood β-hCG, thyroid hormone levels (TSH, fT3, fT4), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and urine ketone levels were obtained from all participants. The CF thickness of each participant was measured to demonstrate the relation between CF thickness and HG.
Results: The mean gestational age was 8.69 (± 2.15) weeks in the HG group and 8.92 (±2.14) weeks in the control group (p=0.6). The HG group had significantly higher urine ketone levels (+2.7) compared to the control group (+0.1) (p<0.001). The CF thickness was significantly higher in the HG group (16.02 mm) than in the control group (13.50 mm) (p=0.02).
Conclusion: The mean chorion frondosum thickness (CF) was significantly higher in the HG group than the healthy controls. This finding may also constitute clinical prediction, in addition to indicating pathophysiology.

Anahtar Kelimeler

chorion , hyperemesis gravidarum , ultrasonography

Etik Beyan

The local ethics committee of Izmir Bakircay University approved the trial with 865 reference IDs. All procedures performed in the current study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Destekleyen Kurum

No funding was used for the study.

Teşekkür

No acknowledgement for the study.

Kaynakça

• Verberg MFG, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update. 2005 Oct;11(5):527–39.
• Roseboom TJ, Ravelli ACJ, van der Post JA, Painter RC. Maternal characteristics largely explain poor pregnancy outcome after hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 2011 May;156(1):56–9.
• Veenendaal M, van Abeelen A, Painter R, van der Post J, Roseboom T. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011 Oct;118(11):1302–13.
• Kaufmann P, Black S, Huppertz B. Endovascular Trophoblast Invasion: Implications for the Pathogenesis of Intrauterine Growth Retardation and Preeclampsia. Biol Reprod. 2003 Jul;69(1):1–7.
• Dommisse J, Tiltman AJ. Placental bed biopsies in placental abruption. BJOG. 1992 Aug;99(8):651–4.
• Smith GCS, Fretts RC. Stillbirth. The Lancet. 2007;370(9600):1715–25.
• Chen JZJ, Sheehan PM, Brennecke SP, Keogh RJ. Vessel remodelling, pregnancy hormones and extravillous trophoblast function. Mol Cell Endocrinol. 2012;349(2):138–44.
• Ali AI, Nori W, Abdulrahman Hadi BAl. Hyperemesis gravidarum and risks of placental dysfunction disorders. J Pak Med Assoc. 2021 Dec 1;71 9)(12):S24–8.
• Niemeijer MN, Grooten IJ, Vos N, Bais JMJ, van der Post JA, Mol BW, et al. Diagnostic markers for hyperemesis gravidarum: A systematic review and metaanalysis. Am J Obstet Gynecol. 2014;211(2):150.e1-150.e15.
• Vandraas KF, Vikanes Å V, Støer NC, Vangen S, Magnus P, Grjibovski AM. Is hyperemesis gravidarum associated with placental weight and the placental weight-to-birth weight ratio? A population-based Norwegian cohort study. Placenta. 2013;34(11):990–4.
• Koudijs HM, Savitri AI, Browne JL, Amelia D, Baharuddin M, Grobbee DE, et al. Hyperemesis gravidarum and placental dysfunction disorders. BMC Pregnancy Childbirth. 2016;16(1):374.
• Niebyl JR. Nausea and Vomiting in Pregnancy. New England Journal of Medicine. 2010 Oct;363(16):1544–50.
• McCarthy FP, Khashan AS, North RA, Moss-Morris R, Baker PN, Dekker G, et al. A Prospective Cohort Study Investigating Associations between Hyperemesis Gravidarum and Cognitive, Behavioural and Emotional Well-Being in Pregnancy. PLoS One. 2011 Nov;6(11):e27678.
• Munch S, Korst LM, Hernandez GD, Romero R, Goodwin TM. Health-related quality of life in women with nausea and vomiting of pregnancy: the importance of psychosocial context. Journal of Perinatology. 2011;31(1):10–20. Bolin M, Åkerud H, Cnattingius S, Stephansson O, Wikström AK. Hyperemesis gravidarum and risks of placental dysfunction disorders: A population-based cohort study. BJOG. 2013 Apr;120(5):541–7.
• Risnes KR, Romundstad PR, Nilsen TIL, Eskild A, Vatten LJ. Placental Weight Relative to Birth Weight and Long-term Cardiovascular Mortality: Findings From a Cohort of 31,307 Men and Women. Am J Epidemiol. 2009 Sep;170(5):622–31.
• Eskild A, Vatten LJ. Do pregnancies with pre-eclampsia have smaller placentas? A population study of 317 688 pregnancies with and without growth restriction in the offspring. BJOG. 2010 Nov;117(12):1521–6.
• Lunney LH. Compensatory placental growth after restricted maternal nutrition in early pregnancy. Placenta. 1998;19(1):105–11.
• Roseboom TJ, Painter RC, De Rooij SR, Van Abeelen AFM, Veenendaal MVE, Osmond C, et al. Effects of famine on placental size and efficiency. Placenta. 2011 May;32(5):395–9.