Outcomes of Symptomatic Gallstone Disease in Pregnant Women: A Retrospective Study

Abstract

Gallstone disease with advanced symptoms is one of the common abdominal emergencies during pregnancy, and it is considered one of the most frequently reported non-obstetric surgical conditions in pregnant women. This study aimed to evaluate the outcomes of surgical cholecystectomy in pregnant women with symptoms of advanced gallstones. A retrospective analysis of 2814 pregnant women attended various wards in governmental and private hospitals in the governorates of Diyala and Kirkuk in Iraq for more than two years, between February 2020 and June 2022. The hospital database was used to confirm the diagnosis of advanced gallstone symptoms in these pregnant women. The incidence of symptomatic gallstones in pregnant women, diagnosis and method of therapeutic management, cholecystectomy according to pregnancy periods and perinatal complications for patients according to therapeutic methods were determined. The results confirmed that out of 2814 pregnancies, only 126 (4%) had symptoms of gallstones. It was found that the majority of cases 67 (53%) were within the first trimester of pregnancy, and the least 29 (23%) in the second trimester. Acute cholecystitis was the generality 84 (67%) diagnosed in pregnant with symptomatic gallbladder disease. only 9 (7%) of pregnant patients had undergone prenatal cholecystectomy versus 117 (93%) were managed conservatively. 20 (16%) cases with undesirable complications were recorded, where 12 cases of low birth weight were noted, 4 of them underwent surgery versus 8 treated conservatively. It was concluded that a large proportion of women suffer from symptoms of gallstones during pregnancy. Most cases can be managed conservatively, and intervention should be performed as often as needed.