Antioxidants in Pregnant Women with Hyperemesis Gravidarum

Objectives: Hyperemesis gravidarum (HG) is relativelya syndrome of unknown cause, and is generally self-limiting.The aim of this study was to evaluate the oxidative status ofthose patients with HG, to compare those values with matchednormal pregnant women and to evaluate the effect of vitaminE as an antioxidant on this syndrome.Research Design and Methods: Measurement of serumvitamin E (vit E) by using High Performance Liquid Chromatography(HPLC), blood reduced glutathione (GSH) andplasma thiobarbituric acid (TBBA) were assayed by thechemical methods, serum zinc (Zn) was measured by atomicabsorption spectrophotometry and fasting plasma tumor necrosisfactor-alpha (TNF-a) by immunoenzymometric assay(EASIA). They were assessed in normal healthy pregnantwomen (group I; n=15) and women who had positive obstetrichistory of hyperemesis in the previous pregnancies HG (groupII; n=30); they were recruited and counseled to commencethe use of antiemetics as soon as they became aware of the toms.Women of HG group were further subdivided into 2main groups; [the study group n=15] included pregnant patientswho used antiemetics besides vitamin E capsules (HG-Egroup) and [the control group n= 15] who were not supplementedwith vitamin E (HG group). Follow up of all pregnantwomen was done. The same measurements were re-evaluatedin both hyperemetic groups when the symptoms had beenimproved.Results: At the start of the study, serum vitamin E, serumZn and blood GSH levels were significantly lower inhyperemesis gravidarum groups (n=30) when compared toNHP women (n=15), while both TBBA and TNF- were significantlyhigher. After the symptoms had been improved,blood GSH, serum Zn and serum vitamin E levels weresignificantly higher while TBBA, and TNF-a levels becamesignificantly lower with vitamin E administration in HG-E(n=15). Also, the signs and symptoms of nausea and vomitingrapidly improved and they required lesser period for hospitalizationin HG-E group versus HG (the controls); reflectingthe significant decrease in oxidative stress among HG-E group There were significantly inverse correlation between bothserum zinc and vitamin E with TNF-a and TBBA, and significantpositive correlations between serum vitamin E withserum zinc and GSH in HG-E group.Conclusion: Patients with HG areexposed to oxidativestress, which may have a role in the pathogenesis of the disease. Supplementation with the antioxidant vitamin E couldbe considered in the treatment of HG and to be routinelyadministered in the early pregnancy