Evaluation of the Gallbladder Dysmotility in the Pregnancy

Abstract

Introduction: The hormonal changes that occur during the pregnancy increase the risk of developing gallstones. The im- pact of placental steroid hormones such as elevated estradiol (E2) and progesterone (PGN) continuously affect the biliary lipid storage and gallbladder activity in safe pregnant women. Gallbladder bile quantities of biliary cholesterol begin to increase from the first trimester to the third trimester of pregnancy, along with a steady increase in biliary sludge and gall- stone occurrence. Ultrasound is a widely used method of imaging, and has the advantage of being safe for the pregnants. It is generally considered as the first line for gallbladder disease assessment. The study aimed to reveal whether there was a difference in motility marker values such as Fasting Volume (FV), Postprandial Volume (PPV), and Ejection Fraction (EF) between trimesters with the effect of changing steroid hormones. These parameters were also compared between groups of pregnant and non-pregnant people, considering gestation numbers. Methods: The patient group consists of 50 pregnant women who applied to the gynecology and obstetrics clinic at our hos- pital. 20 healthy non-pregnant women constituting the control group were also included in the present study. The age and parity of the cases were included in the study. The trimesters of the pregnancies were also recorded for the pregnant group. After the fasting on the day of the examination, gallbladder volumes of the patients were measured. After feeding for 45 minutes, gallbladder postprandial volume measurements were obtained. The gallbladder ejection fractions were calculated using these values (EF: [FV-PPV]×100/[FV]). Results: When the PPV mean values between the trimesters were observed, significant difference was not found between the 1st and 2nd trimesters (p>0.05) moreover significant difference was found between the 1st and 3rd trimesters and the 2nd and 3 rd trimesters (p