Haematemesis in Pregnancy
Haematemesis is the vomiting of red or altered ‘coffee-ground’ blood. Haematemesis is defined as the vomiting of blood and indicates bleeding from the upper gastrointestinal tract proximal to the ligament of Treitz, that is, from the oesophagus, stomach, or duodenum. Coffee-ground haematemesis occurs in patients with either gradual blood loss or in those who have recently bled, and is to the result of stomach acid converting haemoglobin to haematin. The causes of haematemesis to be considered in a pregnant woman are the same as for the general population. Oesophageal ulcer is an infrequent cause of haematemesis and is usually benign in this age group. It may be associated with hiatus herniae and reflux oesophagitis. A linear tear in the mucosa at the oesophagogastric junction due to forceful vomiting can result in haematemesis. Portal vein thrombosis can present with haematemesis from oesophageal varices.