Having gallstones during pregnancy: What you need to know

This is an automatically translated article.

The article is expertly consulted by a Doctor of Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International General Hospital.
Changes during pregnancy can affect the functioning of the gallbladder causing gallstones or gallstones. Although not all pregnant women develop gallstones, they can cause symptoms and complications such as gallbladder colic, cholecystitis, cholangitis, and acute pancreatitis due to gallstones. stones affect the baby in the belly.

1. How are gallstones formed?

The gallbladder is a small, pear-shaped organ located just below the liver. The gallbladder stores excess bile that the liver produces to digest fats. When we eat a high-fat meal, the gallbladder releases bile into the small intestine. However, sometimes this process is not so seamless.
If there are not enough bile salts, too much cholesterol, or the gallbladder is not working properly, hard stones called gallstones will form. Gallstones in the gallbladder not only prevent bile from escaping, but they also cause inflammation of the gallbladder, causing severe pain and a medical emergency. When the gallbladder is not working properly and causing many problems, the doctor can remove it, the body will learn to adapt to the changes in the digestive system.

2. How does pregnancy affect the gallbladder?

Women are less likely to develop gallstones than men, but pregnant women are particularly at risk, with an incidence rate of 0.05-0.33%, especially being older, obese, and having a history of gallstones. family because at this stage gallbladder motility decreases and cholesterol saturation in the gallbladder is increased to form stones.
Gallstones are a fairly common disease during pregnancy because the hormones estrogen and progesterone produced during pregnancy make the muscle tissues in the body more relaxed, slowing the secretion of bile and making it easier to form gallstones. as complications. Pregnant women with gallstones may also experience the following symptoms, appearing 1-3 hours after eating a high-fat meal:
Pain in the epigastrium or the upper right side of the abdomen, pain in the abdomen. gallbladder location. The pain can be a dull ache or a sharp, intense pain. The pain may subside after 1 hour or last for several hours. If the pain is severe, lasts >4-6 hours, radiates to the shoulder or back, fever, fatigue, nausea, or vomiting may suggest complications.

3. Having gallstones during pregnancy when pregnant need to go to the hospital in which case?

Some pregnant women can develop gallstones without any symptoms. This disease is also known as "silent gallstones". Usually this condition will not affect gallbladder function, but when gallstones move or cause complications, it can cause gallbladder pain.
Sometimes the symptoms will go away within 1-2 hours, sometimes it can be long, making the pregnant woman extremely worried. If a pregnant woman has the following symptoms and does not go away within 1-2 hours, she should go to the hospital immediately:
Chills and/or low-grade fever; Nausea and vomiting; Abdominal pain lasting more than 5 hours. Dark urine; Jaundice; Light-colored stools These are all signs that gallstones are starting to cause inflammation and infection.

4. Treatment for pregnant women with gallstones during pregnancy

If a pregnant woman has gallstones without any serious and uncomfortable symptoms, her doctor will prescribe medical treatment with drugs to relieve symptoms or no treatment at all during pregnancy. Gallstones will not usually cause any adverse effects on the fetus and the growth of the fetus will not make the gallstones larger. However, if gallstones prevent the gallbladder from expelling bile or cause persistent pain, weight loss, or complications, surgery may be necessary.
Going forward with surgery while pregnant is not an ideal treatment, but it can be done safely to remove the gallbladder. Gallstones can be removed by endoscopic retrograde cholangiopancreatography (ERCP). The doctor will use a flexible endoscope inserted from the mouth to the duodenum and into the common bile duct, stones will be removed through this tube, the pregnant woman's abdomen will be covered so that the fetus is not affected.
Another method is laparoscopic or open cholecystectomy, performed during the second or third trimester of pregnancy. Cholecystectomy is the 2nd most common type of surgery during pregnancy, after the most common adjuvant surgery is removal of the appendix.

5. Reduce the risk of gallbladder complications during pregnancy

There is no way to reduce the risk of gallbladder-related complications. Cholestasis or gallstones during pregnancy is often associated with pregnancy hormone changes in women with certain genes, but is not a common phenomenon. Because the cause is genetic, about 90% of women who have had it once will have it again in the next pregnancy.
Building a healthy, low-fat, high-fiber diet during pregnancy can reduce the risk of severe gallstone complications and keep both mother and baby healthy.

6. If you have gallstones, should you get pregnant?

Women with gallstones who intend to become pregnant should consult a hepatologist about their current medical status and ask for advice on pregnancy. From a theoretical point of view, it is best to treat a stable medical condition before pregnancy. Because while pregnant, there is a medical condition that requires emergency surgery to save the mother, surgery is still required, potentially affecting the fetus, depending on the severity of the disease, the patient's tolerance. mother and baby, gestational age at surgery...

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