Dr Amita Jain, one of the best gallbladder stone surgeons in Delhi in the field of Laparoscopic Surgery explains how gallstones are treated during pregnancy
Gallstones or Cholelithiasis are hardened deposits of digestive fluid (bile) that can form in your gallbladder which is a pear-shaped organ located on the right side of your abdomen, just below the liver.
Gallstones are more common in women than men, and pregnancy is a significant risk factor for developing gallstones. This is because the hormone estrogen increases cholesterol secretion in bile increasing the saturation of bile with cholesterol, which leads to cholesterol crystal formation.
Moreover, estrogen alters bile acid composition, increasing the risk of gallstones. At the same time, progesterone, another pregnancy hormone causes muscle tissue throughout the body to relax, thereby slowing down the release of bile juice causing the formation of gallstones.
Additionally, the growing uterus can put pressure on the gallbladder, which can slow down the flow of bile and increase the risk of gallstone formation. Usually, patients with gallstones remain asymptomatic during pregnancy or they resolve on their own. However, in rare cases, gallstones can cause complications such as inflammation of the gallbladder or obstruction of the bile ducts, which can cause symptoms such as abdominal pain, nausea, and vomiting during pregnancy.
So, how can we treat these troublesome stones during pregnancy? The answer depends on the severity of the symptoms. Dr Amita Jain, one of the most experienced and top laparoscopic surgeons for gallstones in Delhi, discusses the symptoms and treatment of gallstones during pregnancy in this article.
Symptoms of Gallbladder Stone during pregnancy
- Intense itching
- Pain in the upper right part of the stomach or ribs.
- Nausea and vomiting
- Jaundice—where a person’s eyes and skin become yellow due to a build-up of bilirubin in the bloodstream.
- Fever and chills
- Sometimes pregnant women experience pain under the right shoulder
Treatment of Gallbladder Stone during pregnancy
The management of gallstones in pregnancy depends on the severity of the symptoms and the stage of the pregnancy. Generally, treatment options for gallstones in pregnancy include:
First Trimester:
Surgery for the removal of gallstones during the first trimester of pregnancy is generally not recommended due to the increased risk of harm to the developing fetus. So, the preferred treatment for gallstones is observation and monitoring. Pain management medications such as acetaminophen may be recommended if the symptoms are mild.
Second Trimester:
Surgery may be considered during the second trimester if the symptoms are severe or if there are complications such as inflammation of the gallbladder. Laparoscopic cholecystectomy is the preferred surgical approach during the second trimester, which involves making several small incisions in the abdomen to remove the gallbladder. It is considered to be the safest surgical option as it poses minimal risks to the fetus.
Third Trimester:
During the third trimester, surgery for gallstones is generally avoided due to the increased risk of preterm labour. Pain management medications may be recommended to manage symptoms, and in rare cases, an ERCP Endoscopic retrograde cholangiopancreatography may be necessary to remove gallstones that have migrated into the bile duct. If surgery is deemed necessary, it should be delayed until after delivery.
If surgery is not an option or is deemed too risky for the mother or fetus, non-surgical treatments such as medications or dietary modifications may be used to manage symptoms. These treatments can help to reduce the size of the gallstones and alleviate pain and other symptoms.
So, don’t ignore the symptoms and consult a doctor about your treatment options.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi