Maternal-Fetal Medicine, Obstetrics and Gynecology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
Gastroenterology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
BMJ Case Rep. 2024 Jun 24;17(6):e258792. doi: 10.1136/bcr-2023-258792.
Nausea and vomiting during pregnancy are very common; however, when persistent symptoms lead to severe malnutrition, other conditions should be considered. We present a patient with severe postprandial nausea and vomiting resulting in 120 lb weight loss. She was treated for presumed hyperemesis gravidarum but diagnosed with achalasia type 1 upon further work-up. The pregnancy was further complicated by fetal growth restriction, shortened cervix and preterm premature rupture of membranes, and resulted in delivery at 26 weeks of gestation. Postpartum, she underwent a peroral endoscopic procedure and has returned to normal body mass index.The differential for nausea/vomiting is broad, and major medical conditions can manifest for the first time during pregnancy. Severe malnutrition adversely affects maternal and fetal health. Further work-up should be pursued when symptoms cannot otherwise be explained.
怀孕期间恶心和呕吐很常见；然而，当持续的症状导致严重的营养不良时，应考虑其他情况。我们介绍了一位患者，她有严重的餐后恶心和呕吐，导致体重减轻 120 磅。她被诊断为妊娠剧吐，并接受了相应的治疗，但进一步检查发现她患有 1 型贲门失弛缓症。该妊娠进一步复杂化，出现胎儿生长受限、宫颈缩短和胎膜早破，导致妊娠 26 周时分娩。产后，她接受了经口内镜下的治疗，现已恢复正常的体重指数。恶心/呕吐的鉴别诊断范围很广，主要的医疗状况可能在怀孕期间首次出现。严重的营养不良会对母婴健康造成不良影响。当症状无法用其他方式解释时，应进一步进行检查。
