BILIARY SLUDGE AND GALLSTONES IN PREGNANCY - INCIDENCE, RISK-FACTORS,AND NATURAL-HISTORY

Objective: To evaluate the incidence and symptoms of and risk factors for biliary sludge and gallstones during pregnancy and to assess the n atural history of these conditions in the first year after delivery. D esign: Cohort study. Patients: A total of 272 pregnant women recruited in the first trimester. Measurements: Biliary sludge and gallstones w ere diagnosed using ultrasonography, both during pregnancy and after d elivery. Predictors of the presence or disappearance of sludge and sto nes were examined. Main Results: Overall, from the first trimester of pregnancy until the immediate postpartum period, 67 women were newly d iagnosed with biliary sludge, and 6 women were newly diagnosed with ga llstones. The respective incidence rates were 31% (95% CI, 25% to 37%) and 2% (95% CI, 0.2% to 4%). During pregnancy, 28% of women experienc ed biliary pain, which was associated only with presence of stones. Af ter delivery, 92 women had sludge and 23 had stones. Sludge disappeare d in 61 % of these women (CI, 50% to 73%) after a mean follow-up of 5 months, and stones disappeared in 28% of women (CI, 10% to 46%) after 9.7 months of follow-up. Conclusions: Biliary sludge occurred frequent ly during pregnancy but was generally asymptomatic and often disappear ed spontaneously after delivery. Gallstones were much less frequent an d were more likely to be associated with biliary pain.