Gallstones waiting list care in pregnancy

Overview

Gallstones are small, hard stones that form in the gallbladder, a small organ under the liver that stores bile (a fluid that helps digest fat). During pregnancy, gallstones are common because hormonal changes can slow down gallbladder emptying. If you are waiting for treatment (such as surgery) after your pregnancy, you may need special care to manage symptoms and avoid complications.

Yes, gallstones are fairly common during pregnancy. Around 5 to 12 out of every 100 pregnant women develop gallstones, though many do not have symptoms.

It affects pregnant women, especially those who are overweight, have had multiple pregnancies, or have a family history of gallstones. It is more common in the second and third trimesters.

Symptoms

Common symptoms

• Pain in the upper right side of the belly (abdomen), often after eating fatty or rich foods.
• Nausea or vomiting.
• Indigestion or bloating.
• Pain that may spread to the back or right shoulder blade.

Symptoms in children

• Gallstones are uncommon in children; if they occur, symptoms are similar to adults.

Symptoms in older adults

• In older adults, symptoms may be less typical, such as general discomfort or loss of appetite. This article focuses on pregnancy.

Causes

Main causes

• Gallstones form when bile contains too much cholesterol or bilirubin, or when the gallbladder does not empty completely.
• During pregnancy, higher levels of the hormone estrogen can increase cholesterol in bile, and progesterone can slow gallbladder emptying.

Risk factors

• Being overweight or obese.
• Having a family history of gallstones.
• Having had multiple pregnancies.
• Rapid weight loss or a high-fat diet.
• Certain medical conditions like diabetes or sickle cell disease.

When to see a doctor

See a doctor urgently if:

• If you have severe belly pain that does not go away.
• Fever or jaundice.
• Vomiting and unable to keep fluids down.

Book a routine appointment if:

• If you have mild, occasional pain after meals or indigestion that keeps coming back.
• Mention these symptoms to your midwife or GP at your next appointment.

Diagnosis

Your doctor will ask about your symptoms, do a physical exam, and likely order an ultrasound scan of your belly. An ultrasound uses sound waves to create images of your gallbladder and can show stones.

Tests that may be done

• Ultrasound of the abdomen.
• Blood tests to check for infection or jaundice.
• Sometimes an MRI or a special scan called a HIDA scan if more detail is needed.

What to expect at your appointment

The ultrasound is painless and safe during pregnancy. You will lie on a bed while a small handheld device is moved over your belly. The doctor or technician will press gently. The test usually takes about 15 to 30 minutes. You may be asked to fast (not eat or drink) for a few hours before the scan.

Treatment

Treatment for gallstones during pregnancy depends on how bad your symptoms are. In most cases, surgery (removing the gallbladder) is postponed until after the baby is born. While you wait, care focuses on managing pain and preventing complications. Medicines can be used to treat pain or infection, but your doctor will choose options that are safe in pregnancy.

Self-care at home

• Eat small, low-fat meals more often.
• Avoid fried, greasy, or rich foods that trigger pain.
• Stay hydrated with water.
• Rest when you have discomfort.
• Use a warm compress (not too hot) on your belly for mild pain.
• Keep a food diary to identify trigger foods.

Medical treatments

Your doctor may prescribe pain relievers that are safe during pregnancy. Antibiotics may be used if an infection is suspected. In rare severe cases, a procedure called ERCP (endoscopic retrograde cholangiopancreatography) might be done during pregnancy if a stone is blocking a bile duct. This involves a thin tube passed through your mouth to remove the stone. Surgery to remove the gallbladder (cholecystectomy) is usually scheduled for after you give birth, unless you have a serious complication.

When is surgery considered?

Surgery is usually recommended after delivery if you had symptoms during pregnancy. If you develop a complication like cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or jaundice, surgery may be done during pregnancy. Your healthcare team will decide the best timing based on your individual situation.

Living with this condition

While waiting for treatment, most women can manage gallstones with lifestyle changes. Keep pain relief options on hand as advised by your doctor. Know the warning signs that require urgent care. Stay in touch with your healthcare team.

Lifestyle tips

• Eat a low-fat, high-fiber diet with plenty of fruits, vegetables, and whole grains.
• Stay physically active as much as your pregnancy allows – walking is good.
• Avoid crash diets or rapid weight loss.
• Drink enough water.

Diet and exercise

Aim for small, frequent meals. Include lean proteins like chicken or fish, and healthy fats in moderation. Avoid large, fatty meals. Exercise: gentle walking, swimming, or prenatal yoga are safe. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Living with gallstones while pregnant can be stressful. Pain and worry about your baby’s health can affect your mood. It’s important to talk about how you feel with your partner, family, or a healthcare professional. If you feel overwhelmed, anxious, or depressed, please seek support. In an emergency, call your local crisis helpline.

Prevention

While gallstones during pregnancy are not always preventable, you can lower your risk by maintaining a healthy weight before and during pregnancy, eating a balanced diet low in saturated fats, and staying active. Avoid rapid weight loss.

Vaccines

Not applicable.

Screening programmes

There is no routine screening for gallstones in pregnancy.

Complications

If left untreated

• Cholecystitis (infection and inflammation of the gallbladder).
• Pancreatitis (inflammation of the pancreas, which can be serious for both mother and baby).
• Obstruction of the bile duct causing jaundice.
• Severe infection spreading through the body.

Long-term outlook

With proper care, the outlook for both mother and baby is very good. Most pregnancies with gallstones proceed normally, and treatment after delivery is safe and effective. Even if surgery is needed during pregnancy, it is often successful with careful monitoring. Your healthcare team will guide you through every step.

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