BILIARY DISEASE DURING PREGNANCY

BACKGROUND: Biliary disease during pregnancy is rare and the need for surgery in these cases is controversial. We evaluated our experience w ith biliary disease during pregnancy with regard to outcome and cost c ontainment. PATIENTS AND METHODS: We reviewed the clinical course of p regnant women with biliary disease at the University of California at Los Angeles and Olive View-UCLA Medical Centers from 1988 to 1993. RES ULTS: Seventy-two of 46,075 pregnant women presented with biliary dise ase (incidence 0.16%). Sixteen underwent surgery while pregnant, 5 in the first and 11 in the second trimester. No maternal or fetal deaths occurred secondary to medical or surgical management of biliary diseas e. Patients who were treated medically at initial presentation had a 6 9% rate of relapse prior to delivery compared to no relapses in those treated surgically (P < 0.01). Patients who experienced relapse spent an average of 3.0 additional days in hospital. CONCLUSION: Surgical th erapy for biliary disease performed in the second trimester of pregnan cy does not increase morbidity and may help reduce relapses and additi onal days in hospital.