What is cholecystitis during pregnancy?
Cholecystitis is inflammation of the gallbladder, which usually is caused by obstruction of a tube called the cystic duct, which carries a substance called bile to a series of other ducts that take the bile to the small intestine. Usually, the obstruction is the result of what doctors call cholelithiasis, meaning the presence of gallstones, which usually are made of cholesterol or bilirubin. Cholecystitis can develop during pregnancy because of hormonal changes and because the movement of bile is slowed, allowing stones to grow and accumulate. Although many people have some level of cholelithiasis, they are not always big enough or in the right location to obstruct the cystic duct. So they do not usually develop cholecystitis. Because pregnancy stimulates gall stone buildup, repeated pregnancies increase your chances of suffering cholecystitis in middle age.
Classically, gallbladder pain is in the right upper quadrant (RUQ) of the abdomen, meaning anywhere from the right side to the middle of the upper abdomen. The location of the pain varies more often in pregnant women than in non-pregnant women. Cholecystitis can be acute, meaning that you experience an episode of severe abdominal pain that develops quickly, or it can be chronic, meaning that your condition waxes and wanes over many months or years.
How common is cholecystitis during pregnancy?
Gallstones have been reported to be present in 1 to 3 percent of pregnant women, while symptomatic problems resulting from gallstones, including cholecystitis, have been reported at rates ranging from 0.05 to 8 percent of pregnancies.
How is cholecystitis during pregnancy diagnosed?
Initially, certain findings on the physical examination of your abdomen offer clues that you may have cholecystitis. You will get blood tests to reveal gall bladder issues and the presence of infection. Definitive diagnosis is achieved with imaging tests, such as abdominal ultrasound and endoscopic ultrasonography (EUS, ultrasound through a special tube inserted through your throat). Other imaging tests that could be used, but that doctors try to avoid in pregnancy because they expose the fetus to some ionizing radiation, include a HIDA scan and computed tomography (CT) scanning.
Does cholecystitis cause problems during pregnancy?
Cholecystitis causes severe pain and also can produce low-grade fever. If not treated, the condition can lead to the rupture of the gallbladder and other complications that threaten your life.
Does cholecystitis cause problems for the baby?
If you have a fever and dont treat it, this can increase a babys risk of having congenital defects involving the heart and other organs. If you develop severe complications, such as gallbladder rupture, then the baby is at risk, due to the fact that your life is at risk.
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the cholecystitis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat cholecystitis during pregnancy?
When cholecystitis has not led to complications, it can be handled with conservative management, meaning that you take antibiotics and pain medication while physicians monitor your condition. This often is the favored option during pregnancy, since the alternative is surgery. Because there are a large number of categories of antibiotics and pain medications, there are medical regimens for cholecystitis that are considered safer for pregnancy.
Who should NOT stop taking medication for cholecystitis during pregnancy?
It is very important NOT to stop taking antibiotics without consulting your physician. If you have a reaction to a particular antibiotic, a different antibiotic can be substituted, but you need to be on the same page as your doctor with this. Pain medications can be adjusted in consultation with your physicians.
What should I know about choosing a medication for my cholecystitis during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for cholecystitis when I am breastfeeding?
Because there are a large number of categories of antibiotics and pain medications, there are medical regimens for cholecystitis that are considered safer for nursing mothers.
What alternative therapies besides medications can I use to treat my cholecystitis during pregnancy?
The alternative to medications is the definitive treatment for cholecystitis, a surgical procedure called cholecystectomy, where the gallbladder is removed. This can be done laparoscopically, where a few small incisions are made in different parts of your abdomen, and the operation is conducted through a tube. It also can be done as an open procedure.
What can I do for myself and my baby when I have cholecystitis during pregnancy?
It is very important to follow the instructions of your physician.
Resources for cholecystitis in pregnancy:
For more information about cholecystitis during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations: