At present, there is no consensus regarding the definition of vomiting in pregnant women (lat. Emesis gravidarum) and there are no widely used diagnostic criteria unambiguously for vomiting in pregnant women. Various definitions are based on symptoms, sometimes in combination with laboratory tests. At the same time, vomiting in pregnant women is the most common cause of hospitalization in the first trimester of pregnancy.

The objective of the meta-analysis and systematic review was to summarize the currently available evidence of the diagnostic value of various biomarkers for vomiting in pregnant women. Certain biomarkers could help to diagnose and shed light on the still obscure etiology of the disease.

A search was performed in the Medline and Embase medical databases to find diagnostic markers for the presence or severity of vomiting during pregnancy. The authors of the book defined pregnancy-induced vomiting as any combination of nausea, vomiting, dehydration, weight loss or hospitalization due to nausea and / or vomiting in the absence of any other objective reason for such complaints.

The authors found 81 articles with the study of the significance of 9 biomarkers. Although 65% of all studies included only cases of vomiting of pregnant women with advanced ketonuria, no association was found between the development of ketonuria and the presence or severity of vomiting in pregnant women, which has was established according to 5 studies. In the analysis of 26 studies, it was found that when H. pylori (in most studies, a Helicobacter serodiagnosis was performed, i.e. the determination of IgG) increases the risk vomiting in pregnant women 3 times compared to the control group of pregnant women who did not have the above symptoms (relative risk 3.2, 95% confidence interval 2.0-5.1, sensitivity 73%, specificity 55%).

Studies in which human chorionic gonadotropin, thyroid hormones, leptin, estradiol, progesterone and leukocyte count have been studied as markers, have shown conflicting data on the relationship of the above markers with the development of vomiting in pregnant women. Determining the number of lymphocytes was somewhat more important.

In conclusion, the authors note that there is currently no evidence of the use of ketonuria as a diagnostic marker for vomiting in pregnant women. At the same time, a serological test to diagnose an infection caused by H. pylori may be useful in a number of patients.