Gallbladder disease is one of the top non-obstetric causes for hospitalization in the first year after giving birth. The most common type of gallbladder disease is cholelithiasis, also called gallstones.
Gallstones are hardened deposits in your gallbladder, which is a small organ underneath your liver that stores bile (the fluid that aids digestion). A healthy gallbladder releases bile into the intestine to help process the fat in your food.
During pregnancy, estrogen and progesterone levels are high. This can inhibit the gallbladder from contracting properly and releasing bile into the intestine. The estrogen also causes the concentration of biliary cholesterol in the bile to gradually increase throughout pregnancy, which may cause biliary sludge (a precursor to gallstones) and gallstones.
Gallbladder disease can also develop 2-4 months postpartum, due to hormone changes and rapid weight loss.
Gallstones and biliary sludge are fairly common, especially during pregnancy or postpartum. Up to 30% of pregnant or postpartum women experience biliary sludge and 12% experience gallstones. They often have no symptoms and go unnoticed. However, in 1-3% of postpartum women, they lead to hospitalization and the surgical removal of the gallbladder.
While pregnancy (and being female) is a well-established risk factor, additional risk factors contributing to the formation of gallstones include:
Sometimes gallstones are asymptomatic and you don’t even know they’re there. In that case, they don’t typically require treatment. Also, in 60% of cases, the biliary sludge and gallstones disappear after childbirth, when estrogen levels decrease.
However, if they do cause symptoms, the recommended treatment is usually cholecystectomy, which is the surgical removal of the gallbladder. The rate of hospitalization for biliary diseases is approximately 0.5% of all births, and nearly all hospitalizations include a cholecystectomy. For women hospitalized during pregnancy, the procedure is usually performed after delivery and pain medication may be prescribed in the meantime.