Which condition affecting pregnant women may predispose to Mallory-Weiss tears?

• A. Alcohol use disorder
• B. Chronic NSAID use
• C. Rumination syndrome
• D. Hyperemesis gravidarum

Answer: (D)

Mallory-Weiss tears are mucosal lacerations at the gastroesophageal junction caused by forceful retching or vomiting. In pregnancy, the predisposition comes from hyperemesis gravidarum, which produces prolonged, repetitive vomiting and retching, creating the mechanical stress that tears the mucosa. While alcohol use can also lead to these tears, in pregnant patients the relevant condition is hyperemesis gravidarum. NSAID use can cause gastritis or ulcers but not the characteristic retching-induced tear, and rumination syndrome involves regurgitation without the same violent vomiting pattern. So hyperemesis gravidarum best explains the increased risk during pregnancy.