Mallory-Weiss Syndrome complicating pregnancy – A rare near miss

Mallory-Weiss como complicación grave de hiperemesis gravídica. Reporte de caso y revisión de la literatura

“…Los factores desencadenantes más comunes incluyen vómito en episodios intensos, arcadas o hipo, bulimia, hernia hiatal, gastritis infecciosa o haber recibido terapia endoscópica. En raras ocasiones se reporta la hiperemesis gravídica en el primer trimestre del embarazo [3][4][5] . Estudios sobre hiperemesis gravídica han informado que las manifestaciones graves y refractarias de la enfermedad han dado lugar a resultados adversos graves [6][7][8] , por lo que es una de las indicaciones más comunes de hospitalización durante el embarazo, más allá de las consecuencias maternas y fetales que puede presentar 6,7 .…”

Mallory-Weiss Syndrome in Pregnancy

“…MWS during the third trimester may have the possibility of massive hematemesis, and preparation shall be considered for urgent blood transfusions, emergency endoscopic hemostasis, and caesarean section, although MWS in pregnancy is extremely rare. (Suzuki et al, 2015;Chopra et al, 2019)…”

“…Clinically, MWS can occur in any individual with severe bouts of vomiting, coughing, or vomiting or after any event that triggers a sudden rise in intragastric pressure. (Chopra et al, 2019;Hussain et al, 2020).…”

“…Induction and extubation should be performed according to standard protocols. (Chopra et al, 2019) Cases of massive hematemesis due to MWS in the third trimester are rare. So far, during the peripartum period, only two cases of massive hematemesis during the third trimester with blood transfusion and one case during the postpartum period have been reported in the literature.…”

“…Common precipitating factors include episodes of severe vomiting, retching, or hiccups as in patients with alcoholism, bulimia, hiatal hernia, infectious gastritis or those receiving gastroscopy. This syndrome is less frequently associated with hyperemesis gravidarum in the first trimester of pregnancy, and on rare occasions during the third trimester or even postpartum (Suzuki et al, 2015;Chopra et al, 2019). Gravidarum (Lata et al, 2019) Other conditions that can cause esophageal problems, such as: chest or stomach trauma, severe or prolonged hiccups, severe coughing, lifting or pressing, gastritis, inflammation of the lining of the stomach, hiatal hernia which occurs when part of the stomach is pushed through part of the diaphragm, spasms.…”