The Effect of Pregnancy on Pepsinogen Secretion and its Possible Role in Protection of Peptic Ulcer Disease

This study is aimed to see the effect of pregnancy on pepsinogen secretion and its possible protective role against ulceration. Fifty pregnant women without symptoms ofpeptic ulcer disease were studied for serum pepsinogen level. These levels were compared with those of a control group composed of age-matched, nonpregnaflt healthy women. An elevated level ofserum pepsinogen wasfound during pregnancy. Fourteen percent ofpregnant women had low levels ofpepsinogen while 20% showed normal pepsinogen level, because they were associated with severe anemia. Regular feeding, good nutrition. and emotional tranquility during pregnancy were favourable factors to reduce the chances of ulceration. Increased secretion of estrogen and progesterone, increased secretion ofgastric mucus, bicarbonate and prostaglandins during pregnancy enhance cytoprotection against ulceration. Increased secretion ofhistaminase blocks or destroys the histamine action at the parietal cells which slows down acid secretion and helps to avoid ulcer formation. ResuJts The mean serum pepsinogen level for pregnant women was 856.0 ± 474.1 units/mll24 h (mean ± lIMA: Volume 21, 1989 Page 57 age (mean age 23.6 ± 3.1) without symptoms or past medical history of peptic ulcer disease were selected for this study. Thirty non-pregnant healthy women within the same age group were also studied as controls. Pregnancy was confirmed by ultrasound and/or other specific tests. Cases were selected from the Government Maternity Hospital. Hyderabad. Pepsinogen studies were conducted in the Department of Gestroenterology. Osmania General Hospital, Hyderabad. Eighteen of the pregnant women were in the second trimester while 32 were in the third trimester. A detailed antenatal checkup was done in each case. There were 15 primigravid and 35 multigravidae women in the study. Blood samples were collected during routine check ups and serum pepsinogen levels were estimated by the method of Mjrsky et al using hemoglobin as a substrate. Statistical analysis was carried out by using Student "t" test. Reprint Requests: Dr. M. Mujahid Ali Department of Gastroenterology Osmanio Generat Hospital Hyderabad (A.P.), India From the Department oj Gastroenterology Osmania General Hospital Hyderabad (A .P.), India Several factors such as blood group 0, smoking, and stress have been shown to have an effect on gastric secretion of both acid and pepsin.'-l Gastric secretion has also been shown to be altered in some disease conditions.'" Very few reports are available to show gastric acid and pepsinogen secretions during pregnancy.5,' This study was carried out to examine the effect of pregnancy on serum pepsinogen levels and to explore the reasons why females are less susceptible to peptic ulcers during pregnancy. Materials and metbods Fi fly pregnant women between 17 and 31 years of