Gallstones During Pregnancy

I am currently 35 weeks pregnant with my third child.  After almost 2 years of recurrent gallbladder episodes (whereby severe pain was experienced but no visible sign of gallstones was detected in ultrasounds), I had an ulstrasound today that confirmed I have at least one very large stone (too large to pass, according to the tech).  Knowing that this stone will likely not go away -- and therefore continue to present pain and possibly more problems -- would it be a reasonable consideration to a) have it removed before the baby is due (and what sort of risks are involved?) or b) request a cesarean section so that the gallbladder might be removed at the same time as the delivery?

[Kevin Pho, MD]

Hello - thanks for asking your question.

Gallstones are more common during pregnancy.  Between 2.5 and 10 percent of pregnant women have gallstones.  Most are asymtomatic.  However 1 in 1000 women have symptomatic gallstones (as in your case).  There are various approaches to treatment.  Sometimes avoidance of fatty foods, or temporary hospitalization for IV fluids and pain control is all that is needed.  

Laparoscopic removal of the gallbladder is possible in pregnancy.  In the latter stages of pregnancy, the uterus may be in the way and the older "open" approach must be used. The best time to do surgery is the second trimester; risk of miscarriage from surgery is low, and the uterus is usually still small enough not to interfere with the laparoscopic approach.  The risk of miscarriage during a cholecystectomy increases in the third trimester.  

Normally the cholecystectomy is performed after the cesarean section.  Discuss with your surgeon and OB/GYN about your surgical options.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Natalie337]

A related discussion, gallstone and pregnancy was started.