Gallstones During Pregnancy: Safe Management & Treatment Options

Pregnancy significantly increases gallstone risk — up to 12% of pregnant women develop new stones. Symptomatic gallstones complicate 0.1-0.3% of pregnancies. Symptoms: upper right abdominal pain after meals, nausea, vomiting, right shoulder pain, fever (suggests cholecystitis). Diagnosis: abdominal ultrasound (safe, no radiation), blood tests, MRCP without gadolinium if CBD stones suspected. Management: conservative first (low-fat diet, paracetamol, antiemetics, monitoring). Surgery needed for: recurrent biliary colic, acute cholecystitis not responding to antibiotics, gallstone pancreatitis, cholangitis. Timing: first trimester — avoid surgery (miscarriage risk); second trimester — safest period for laparoscopic cholecystectomy; third trimester — conservative preferred, surgery for complications only. Laparoscopic cholecystectomy in second trimester is safe with appropriate modifications (open port insertion, reduced pneumoperitoneum, foetal monitoring).