J. Perinat. Med. 2016; aop *Corresponding author: Nagihan Sari, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Bozok University, Yozgat, Turkey, Tel.: +90-354-2127949, Fax: +90-354-2122789, E-mail: opdrnagihansari@yahoo.com.tr Hüseyin Ede: Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey Yaprak Engin-Ustun: Zekai Tahir Burak Women Health Education and Research Hospital, Gynecology and Obstetrics Department, Ankara, Turkey Ayşe Yeşim Göçmen: Department of Biochemistry, Faculty of Medicine, Bozok University, Yozgat, Turkey Emel Kıyak Çağlayan: Department of Obstetrics and Gynecology, Faculty of Medicine, Bozok University, Yozgat, Turkey Nagihan Sari*, Hüseyin Ede, Yaprak Engin-Ustun, Ayşe Yeşim Göçmen and Emel Kıyak Çağlayan Hyperemesis gravidarum is associated with increased maternal serum ischemia-modified albumin DOI 10.1515/jpm-2015-0421 Received December 8, 2015. Accepted June 22, 2016. Abstract Aim: Our objective was to measure the circulating levels of ischemia-modified albumin (IMA) among pregnant with hyperemesis gravidarum (HEG) and to compare their levels with age- and body mass index (BMI)-matched control pregnant women. Method: The pregnant subjects were classified into the HEG group diagnosed with HEG (n = 45) and age- and BMI- matched control group without a diagnosis of HEG (n = 45) during their pregnancies. Serum IMA, hemoglobin, hema- tocrit, white blood cells, platelet, fasting blood glucose, creatinine, lipid profile, aspartate aminotransferase (AST) urea, alanine aminotransferase (ALT), sodium, potas- sium and thyroid-stimulating hormone (TSH) levels of the groups were measured. Result: Serum hemoglobin, hematocrit, white blood cells, platelet, fasting blood glucose, creatinine, lipid profile, AST, urea, ALT, sodium, potassium and TSH levels of the groups were statistically similar. Serum IMA values were significantly higher in subjects with HEG compared to the subjects without HEG. Conclusions: We found that HEG was related to increased maternal serum IMA levels. HEG might be due to an ischemic intrauterine environment leading to elevated serum IMA concentrations. Keywords: Hyperemesis gravidarum; IMA; oxidative stress. Introduction Approximately 80% of all pregnant women report a varying severity of nausea and vomiting at the time of their pregnancy [1]. The International Statistical Classification of Disease and Related Health Problems, 10 th revision, classified hyperemesis gravidarum (HEG) as sustained and excessive vomiting starting before the end of the 22 nd week of gestation and further classifies HEG into mild and severe forms whereas the severe form involves metabolic problems such as carbohydrate depletion, dehydration, or electrolyte disequilibrium [2]. HEG is portrayed by long-lasting, severe nausea and vomiting, dehydration, remarkable ketonuria, and loss of body weight of  > 5% [1]. Nausea and vomiting are regarded as a normal aspect of pregnancy and are frequent complaints of early preg- nancy. Furthermore, they are commonly accepted as signs of a healthy pregnancy [3]. However, HEG is a potentially life-threatening clinical state that develops in 0.8%–3.2% of all pregnancies [4]. If left untreated, HEG can lead to Wernicke’s encephalopathy, central pontine myelinoly- sis, liver dysfunction and kidney failure. The presence of HEG is also related to preterm delivery, fetal and neona- tal mortality [5]. Previously it was suggested that HEG is associated with low birth weight and intrauterine growth retardation [5] but in one of the large-scale prospective studies investigating associations between HEG and preg- nancy outcome, multivariate analysis have failed to prove a correlation between HEG, birth weight and intrauterine growth restriction [6]. Hormonal, immunological and psychological mecha- nisms have been suggested for the etiology, but none of them has been shown to be the definitive reason for HEG Brought to you by | Cornell University Library Authenticated Download Date | 10/8/16 1:17 AM