Esophageal achalasia in pregnancy.

Achalasia is rare motor disorder of esophageal smooth muscle. It has been linked to malnutrition during pregnancy leading to maternal and fetal mortality. We report a case of achalasia with intrauterine fetal death who succeeded in following pregnancy with good fetal and maternal outcome after operative treatment. A 34-year-old pregnant woman had intrauterine fetal death at 27 gestational weeks due to severe and persistent maternal malnutrition during pregnancy. Achalasia was diagnosed postpartum and myotomy-fundoplasty was performed. She succeeded in normal delivery with a healthy baby 21 months after the operation. This case suggests the effect of severe achalasia of early onset on poor fetal outcome, and the efficacy of surgical myotomy for the improvement of following pregnant outcome.