Management and Outcomes of Symptomatic Gall Stone Disease during Pregnancy

Abstract

Background: Symptomatic gallstone disease during pregnancy is an important cause of maternal morbidity and hospitalization. Its management remains challenging because treatment decisions must consider both maternal and fetal safety. This study aimed to evaluate the management strategies and maternal and fetal outcomes of symptomatic gallstone disease during pregnancy.

Materials and Methods: This prospective observational study included 110 pregnant women diagnosed with symptomatic gallstone disease. Demographic characteristics, obstetric history, clinical presentation, management modalities, and maternal and fetal outcomes were evaluated. Patients were categorized according to conservative management (n = 64) or interventional management (n = 46), including laparoscopic cholecystectomy, open cholecystectomy, and therapeutic ERCP.

Results: Most patients belonged to the 26–30-year age group (39.09%), were multigravida (64.55%), and presented during the second trimester (43.64%). Conservative management was performed in 58.18% of patients, while 29.09% underwent laparoscopic cholecystectomy, 5.45% underwent open cholecystectomy, and 7.27% received ERCP. Symptomatic improvement was higher in the intervention group (95.65%) than in the conservative group (79.69%). Recurrent biliary symptoms (8.70% vs. 34.38%) and hospital readmissions (6.52% vs. 26.56%) were lower following intervention. Pregnancy loss occurred in 2.17% and 3.13% of patients, respectively. Preterm labor was also less frequent following intervention (10.87% vs. 14.06%).

Conclusion: Interventional management was associated with better symptomatic improvement and fewer recurrent biliary events compared with conservative treatment. Individualized treatment and multidisciplinary care are essential for optimizing maternal and fetal outcomes during pregnancy.