Per Oral Endoscopic Myotomy in pregnancy

Abstract

Objective

To report the first successful full-term delivery following Per Oral Endoscopic Myotomy (POEM) performed during pregnancy.

Methods/Background

Achalasia is an esophageal motility disorder characterized by dysphagia, regurgitation, reflux, recurrent vomiting, and weight loss. Achalasia in pregnancy can affect nutritional status of the mother, and subsequently, the child, increasing morbidity and creating potential pregnancy complications. POEM is a novel endoscopic procedure which involves cutting the lower esophageal sphincter to allow food to pass, and is considered a safe and effective management option for achalasia in non-pregnant individuals.

Results

We discuss the case of a patient with achalasia and a prior Heller myotomy who presented with recrudescence of severe symptoms prompting evaluation and treatment with POEM.

Conclusion

This is the first report of successful full-term delivery following POEM performed during pregnancy, demonstrating its feasibility and safety in this patient population when approached with a multidisciplinary team.

Keywords:

• Achalasia
• pregnancy
• per oral endoscopic myotomy

Acknowledgments

We would like to acknowledge Alexander Smirnov, Maya Kiriltseva, Mariya Lyubchenko, Vladimir Nazarov, Anna Botina, Aleksandr Burakov, and Sergey Lapin for providing additional clinical insight into the pregnancy outcomes of their case report.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.