Biliary Disease in Pregnancy: A Diagnostic Dilemma

  • Priyanka H Krishnaswamy MRCOG, Subspecialty Registrar in Urogynaecology, Queen Elizabeth University Hospital, Glasgow

Abstract

Gallstone-related complications are relatively common during pregnancy, with reports of biliary sludge in 5-31% and cholelithiasis in 2-11% of expectant mothers (Maringhini et al. 1993). 1% of these women will develop complications secondary to cholelithiasis, which may lead to increased foetal and maternal morbidity and mortality (Ko et al. 2005). This case highlights the importance of considering a broad spectrum of hepatobiliary disorders during pregnancy, including choledocholithiasis and considering urgent ERCP as a safe option for those women with symptomatic complicated cholechodolithiasis.

Keywords: biliary, disease, pregnancy, choledocholithiasis, diagnosis

References

Brodsky, J.B., Cohen, E.N., Brown Jr, B.W., Wu, M.L., and Whitcher, C., 1980. Surgery during pregnancy and fetal outcome, 138, 1165–1167.
Cappell, M., Stavropoulos, S., and Friedel, D., 2018. Systematic review of safety and efficacy of therapeutic endoscopic-retrograde-cholangiopancreatography during pregnancy including studies of radiation-free therapeutic endoscopic-retrograde- cholangiopancreatography. World Journal of Gastrointestinal Endoscopy, 10, 308– 321.
Chan, C.H.Y. and Enns, R.A., 2012. ERCP in the Management of Choledocholithiasis in Pregnancy, 14 (6), 504–510.
Fesenmeier, M., Coppage, K.H., Lambers, D.S., Barton, J.R., and Sibai, B.M., 2005. Acute fatty liver of pregnancy in 3 tertiary care centers, 192, 1416–19.
Kern, J.F., Everson, G., and DeMark, B., 1981. Biliary lipids, bile acids, and gallbladder function in the human female. Effects of pregnancy and the ovulatory cycle, 68, 1229–42.
Ko, C.W., Beresford, S.A., Schulte, S.J., Matsumoto, A.M., and Lee, S.P., 2005. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy, 41 (2), 359–65.
Linz, C.M., Murphy, C.J., Conteh, L., Chen, W., and Mumtaz, K., 2016. Acute Fatty Liver of Pregnancy Masquerading as Choledocholithiasis, 111 (1), S903–S903.
Maringhini, A., Ciambra, M., and Baccelliere, P., 1993. Biliary sludge and gallstones in pregnancy: incidence, risk factors, and natural history, 119, 116–20.
Pandey, M. and Shukla, V., 2003. Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer, 12, 269–272.
Tang, S.J., Mayo, M.J., Rodriguez-Frias, E., Armstrong, L., Tang, L., and Sreenarasimhaiah, J., 2009. Safety and utility of ERCP during pregnancy, 69, 453–461.
Tham, T.C., Vandervoort, J., Wong, R.C., Montes, H., Roston, A.D., and Slivka, A., 2003.
Safety of ERCP during pregnancy, 98, 308–311.
The American Society for Gastrointestinal Endoscopy (ASGE), 2012. Guidelines for endoscopy in pregnant and lactating women. Gastrointestinal Endoscopy, 76, 18–24.
The Italian Association for the Study of the Liver (AISF), 2016. AISF position paper on liver disease and pregnancy, 48, 120–137.
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), 2017. Guidelines for the use of laparoscopy during pregnancy. SAGES Guidelines.
Williams, E., Beckingham, I., and El Sayed, G., 2017. Updated guideline on the management of common bile duct stones. Gut, 66, 765–782.
Statistics
4 Views | Downloads
How to Cite
Priyanka H Krishnaswamy. (2021). Biliary Disease in Pregnancy: A Diagnostic Dilemma. Innovare Journal of Medical Sciences, 9(3). Retrieved from https://innovareacademics.in/journals/index.php/ijms/article/view/41050
Section
Case Study(s) / Case Report (s)