Pregnancy Complications: Gall Stones

Some minor complications may be associated with gall stones during pregnancy.

Your gall bladder is a tiny, pear-shaped organ tucked behind the right side of your liver and beside your stomach. Its job is to store bile, a digestive fluid produced over a long, continuous period by your liver; your liver produces this substance so slowly it requires a small storage sac for immediate release. It is not a necessary organ in the same way as, say, the heart, but it is conducive to good digestion and its removal is usually avoided unless it absolutely has to be. Bile is a fat emulsifier--it allows fat to be separated out and broken down for proper digestion. As such, a disturbance of the gall bladder is usually noted by the stoppage of this function, which can make a patient intolerant of fatty foods, nauseous, or gassy. If pain is noted, it will generally be on the center-to-right of the upper abdomen.

Most commonly, pain or dysfunction of the gall bladder is the result of the growth of gall stones, a condition called cholelithiasis. Gall 'stones' are actually crystalline deposits of cholesterol, a central component of bile, which solidify as a result of numerous factors, most notably obesity or a high-fat or cholesterol diet. A rough 20% minority of gall stones are instead composed of a bile pigment mixed with calcium deposits. Liver disorders may also be to blame for gall stones--if the liver produces an insufficient level of bile acids, crystallization of cholesterol molecules in the bile may result.

Gallstones are usually non-problematic. They are most frequently discovered not as a result of complications that warranted a search specifically for gallstones but as part of an unrelated ultrasound for another condition or as a part of a pregnancy. Minor abnormalities such as gallstones can, however, sometimes provide a minor complication to pregnancies, as pressure from the expanding uterus is exerted upon the abdominal organs.

If this happens, one can expect the normal symptoms of gall bladder pain to be exacerbated. Usually such symptoms are felt from the right side of the abdomen, often an hour or so after a large meal. These pains result from the lodging of gall stones into one of the ducts emerging from the gall bladder. This can lead to discomfort and potential infection. Generally, however, the risks of surgery in late-stage pregnancy are greater than the risks posed by the gallstones themselves, so the decision to cut may occur on a case-by-case basis. Gall bladder infection is a major concern, as with the infection of even the most minor organ. The risks of eventual bleeding and rupture are potentially grave enough to warrant extraction even under the conditions of pregnancy. The immediacy of the concern is sometimes difficult to tell in the case of infection, depending upon how escalated it has become, so your doctor will likely draw this into the decision as to whether your gall bladder needs extraction, if it indeed turns out to be infected.

Keep in mind that not all cases of gall stones cause infection, and that in fact most do not produce any ill effects in the individual at all. If gall stones were sighted during a sonogram conducted for your pregnancy or for another condition, every chance indicates that you will be just fine and that no complications will occur. In most individuals, the worst-case-scenario is a period of mild internal discomfort nearing the end of the term.

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