GALLBLADDER CONTENTS AND FASTING GALLBLADDER VOLUMES DURING AND AFTERPREGNANCY

Background: A high risk of developing sludge or gallstones has been as sociated with pregnancy. The aim of this study was to relate the preva lence of sludge and gallstones during and shortly after pregnancy to f asting gallbladder volume as an indicator of gallbladder motility. Met hods: The population included 114 apparently healthy pregnant women fr om the Outpatient Clinic of Obstetrics of a large regional hospital an d from the practices of regional midwives. Ultrasonography of the gall bladder was performed at weeks 15, 25, and 35 of gestation and at week 3 and month 6 postpartum. Results: At gestational week 15, 3 women ha d gallstones and 10 had sludge (mean volume, 33.8 ml), and 99 women ha d a normal gallbladder (mean volume, 30.5 ml). At week 25, 1 woman wit h a normal gallbladder formed gallstones and underwent cholecystectomy shortly after, and 22 women had sludge, of whom 13 had a normal gallb ladder at first examination (mean volume, 33.2 ml). In 88 women with n ormal gallbladders (of whom 2 had sludge at week 15) mean volume was 3 1.9 ml. At week 35, 2 women had gallstones, and 21 had sludge (mean vo lume, 30.5 mi). In the remaining 79 women the gallbladders were clear (mean volume, 29.5 ml). Fight women developed sludge and two women gal lstones in normal gallbladders at week 25. Seven women with sludge at week 25 had a normal gallbladder at week 35. Three weeks postpartum on ly 10 of 100 women had sludge (mean volume, 29.1 ml). Of these 10, 9 w omen had a normal gallbladder at week 35. Twenty of 21 women with slud ge at week 35 had normal gallbladders week 3 postpartum. Gallstones fo und at week 35 had disappeared. In the women with a normal gallbladder the mean volume was decreased to 19.7 ml (P < 0.0001). Six months pos tpartum, sludge was found in 6 (mean volume, 18.4 ml) of 93 women (mea n volume, 20.3 ml), of whom 5 had a normal gallbladder at week 3 postp artum. Only 61 women showed a normal gallbladder at each examination o f the study. No differences in patient characteristics were found betw een women with normal gallbladders and those with sludge or gallstones . Conclusions: Fasting gallbladder volume was increased in all pregnan t women. This could not explain the formation of sludge or gallstones during gestation. Decrement of gallbladder volumes after delivery was faster in normal, clear gallbladders. More than a prerequisite, increa sed fasting gallbladder volume seemed to be a permissive factor of pre gnancy-associated gallstone formation.