Hyperemesis gravidarum is the most severe spectrum of gastrointestinal comp
laints in pregnant women. Our purpose is to describe an association of Heli
cobacter pylori with hyperemesis gravidarum. Three pregnant women are descr
ibed with the working diagnoses of hyperemesis gravidarum unresponsive to s
tandard therapy. The medical management used to treat Helicobacter pylori i
n these women are elaborated. The persistence of the symptomatology and/or
hematemesis resulted in Helicobacter pylori testing of these women. A 2-wee
k course of antibiotics and a proton pump inhibitor or H-2 receptor antagon
ist resulted in resolution of the hyperemesis. A discussion of the incidenc
e, diagnosis, and management of Helicobacter pylori in pregnancy is describ
ed. When the symptoms of hyperemesis gravidarum are persistent into the sec
ond trimester, active peptic ulcer disease from Helicobacter pylori should
be included in the differential diagnoses.