Q. I am 31 weeks pregnant with gallstones. Should I get it removed before delivery?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 02, 2020

Hello doctor,

I am 31 weeks pregnant, and the ultrasound showed I have gallstones and pancreatitis. My amylase test result came high as 116. Is this an emergency or life-threatening since it is high? Can I manage the symptoms until delivery? I want to know the risk at 116.

#

Hello,

Welcome to icliniq.com.

One high amylase level cannot predict pancreatitis. However, if you have serial testing of serum amylase and that showed an upward surge, then it is a concerning thing. Additionally, abdominal pain is the hallmark of pancreatitis, not just a single blood test of amylase.

The size of gall bladder stones is an important thing to be considered before recommending the final opinion of mine. So I want you to recheck amylase or upload the result if you have it already. Also, upload the ultrasound report to see the sizes of stones and ultrasonic evidence of pancreatitis or gall bladder inflammation called cholecystitis. I would be able to guide you afterward.

Thank you doctor,

I am attaching my reports here.

#

Hello,

Welcome back to icliniq.com.

I was able to see the images of ultrasound, but all were baby images (attachment removed to protect patient identity). None of them seem focussing liver, gall bladder, and pancreas.

You have one amylase of 116. However, lipase which is another marker to tell whether you have pancreatitis, is normal. So I do not think that you have pancreatitis while just looking at these blood tests. The rest of your blood tests, particularly of sugars, liver function tests, are also normal. So no problem with that.

I did ask you, but you forgot to mention whether you have or had any abdominal pain? And kindly share the ultrasound report (not only images). The report will help us to clear any doubts.

Thank you doctor,

I do not have the ultrasound report. I will see if I can get an early appointment for a full gallbladder, pancreas, and liver ultrasound. Can I get this done at my Gynecologist ultrasound office, or I have to go to an Internal doctor office?

Yes, I am having abdominal pain. It gets worse after eating, I can sit down for five minutes, and the pain will kick at my right side belly, which radiates to the back. These symptoms I have before pregnancy, but I think the pregnancy made it worse.

I saw a GI specialist and showed him the test result, and he said I should go for surgery before 34 weeks. That is why I am scared. He did not tell me if I am at high risk. Will it rupture if I wait for nine weeks to do surgery after delivery? These are my concerns. I feel abdominal pain, and when I touch my upper right side belly, sometimes it feels sore. I will try to get the ultrasound sound extensively for this issue.

#

Hello,

Welcome back to icliniq.com.

Your anxiety is reasonable. But to address your concern, I would need an ultrasound of the gall bladder.

The doctor who suggested surgery made an optimal decision because if this turns out to be gallstones and the size is 1 cm or above, then surgery before delivery is a wise decision. If it is left unattended, this can convert into acute cholecystitis (inflammation of the gall bladder), which negatively impacts maternal and fetal (child) health.

If you do not have stones but only having pain, then there will be no need for surgery, and delivery can be safely performed.


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