الفهرس 
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Abstract
Nausea and vomiting are common in pregnancy, occurring in 70-85% of all gravid women. Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy, affecting 0.8-2.3% of pregnant patient. Multiple pregnancy, hyperthyroidism, molar pregnancy, gastrointestinal disorders, female offspring, gestational trophoblastic neoplasia, diabetes and psychiatric disorders are well-known risk factors of HG. Platelets are known to modulate inflammatory reactions beyond their role in blood coagulation and hemostasis. Therefore, platelet indices, such as the platelet to lymphocyte ratio (PLR) and plateletcrit (PCT) have been found to be associated with inflammatory diseases, such as coronary artery disease,Crohn’s disease and some cancers. However, because there is no enough data in the literature evaluating the relationship between the PLR, PCT and the presence and severity of HG, we investigated this association in the present study.
The aim of this study is to predict the severity of hyperemesis gravidarum by measuring Plateletcrit and in Hyperemesis Gravidarum patients for early diagnosis and management and to improve their quality of life.
In this cross-sectional study, 270 pregnant patient with a diagnosis of HG who will be admitted to Obstetrics and Gynacology Department Suez Canal University Hospital were enrolled. The study population were divided into three groups according to severity of HG: mild, moderate and severe by using modified PUQE score. Blood samples were taken at the time of hospitalization when the symptoms weremost severe. CBC parameters were measured using the Mindray BC 5800 Auto Hematology Analyzer, an automated blood counter.
Out of 270 HG patients, those with moderate/severe HG have higher levels of plateletcrit, platelet count and acetone in urine compared to patients with mild disease while there was no statistically significant difference between patients with moderate and severe disease. plateletcrit % > 0.22 is a significant predictor of presence of moderate/severe HG with sensitivity of 45% and 90% specificity. Plateletcrit % > 0.19 is a significant predictor of presence of HG with sensitivity of 80% and 70% specificity.
Plateletcrit was significantly higher in patients who developed relapse of emesis (0.17 ± SD 0.04% versus 0.21± SD 0.08%) with p value 0.006. In addition, development of chronic hypertension (0.16 ± SD 0.08% versus 0.21± SD 0.08%) with p value 0.001. Along with patients who suffered from psychic trauma of emesis had higher plateletcrit (%) versus those who didn’t (0.17 ± SD 0.07% versus 0.21± SD 0.04%) with p value 0.001. also, ROC analysis showeda significant prediction relapse, with AUC 0.31, p value 0.001, sensitivity