Non-puerperal uterine inversion is an extremely rare gynaecological event that is usually associated with uterine tumours such as submucous or cervical leiomyomas. In this report, we describe a case of uterine inversion due to a large submucous leiomyoma in a 42-year-old multiparous and obese Caucasian woman.
Objective: To investigate the influence of thyroid hormones, beta human chorionic gonadotropin (β-HCG), and free β-HCG (fβ-HCG) in the etiology of hyperemesis gravidarum (HG) and to determine the main hormone that is responsible for the exacerbation of symptoms.Materials and Methods: Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), β-HCG, and fβ-HCG levels were measured twice (before and after hospitalization) in 55 patients with HG and measured once in 64 healthy controls. Serum hormone levels were determined using enzyme-linked immunosorbent assay.Results: Decreased mean TSH and increased mean fT4 levels were found in the pre-treatment serum samples of the HG group compared with the control group. Both differences were statistically significant (p=0.020 and p=0.007, respectively). However, there was no statistically significant difference in mean fT3, β-HCG, and fβ-HCG levels between the pre-treatment serum samples of the HG group and control group. We could not demonstrate any correlation between the levels of β-HCG and thyroid hormones in the HG group; however, fβ-HCG moderately correlated with fT4 levels (r=0.494).
Conclusion:The presence of hyperthyroidism was observed as the leading alteration in HG. In this study, fβ-HCG was demonstrated to have no direct effect on the etiology of HG; however, a possible indirect effect of fβ-HCG in relation with thyroid hormones was indicated. Hyperthyroidism was assessed to be primarily responsible for the symptoms in HG.
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