Your gallbladder may be a relatively small organ, but it can cause big trouble during your pregnancy. Changes during pregnancy can affect how well your gallbladder works. If your gallbladder is affected (not every pregnant woman’s is), it can cause symptoms and complications that could impact your baby’s health.

Knowing the symptoms can help you get medical attention before it get worse.

How does the gallbladder work?

The gallbladder is a small organ that’s roughly the shape of a pear. It’s positioned just below your liver. The gallbladder is a storage organ. It stores extra bile the liver produces that helps the body digest fats. When a person eats a high-fat meal, the gallbladder releases bile to the small intestine.

Unfortunately, this process isn’t a seamless one. Extra substances can form hard stones in the gallbladder. This keeps bile from leaving the gallbladder as easily and can cause problems.

The presence of a gallstone in the gallbladder not only keeps bile from moving, but it can also cause inflammation. This is known as cholecystitis. If it causes severe pain, it can be a medical emergency.

Your gallbladder is intended to be a helpful storage organ. If it doesn’t help you and is causing more problems than benefits, a doctor can remove it. You don’t need your gallbladder to live. Your body will accommodate to the digestive changes that come with having your gallbladder taken out.

How can pregnancy affect gallbladder functioning?

Women are more likely than men to have gallstones. Pregnant women are at an especially high risk because their bodies are making more estrogen.

Added estrogen in the body can lead to an increased amount of cholesterol in the bile, while also reducing gallbladder contractions. Doctors call the slowing of gallbladder contractions during pregnancy cholestasis of pregnancy. This means bile doesn’t escape the gallbladder as easily.

Cholestasis of pregnancy is associated with increased risk for pregnancy complications.

Examples of these complications include:

  • passing meconium (stool) before birth, which can affect baby’s breathing
  • premature birth
  • stillbirth

Symptoms of gallbladder problems during pregnancy

Cholestasis of pregnancy can cause very specific symptoms. These include:

  • intense itching (most common symptom)
  • jaundice, where a person’s skin and eyes take on a yellow tint because there’s too much bilirubin (a waste product of breaking down red blood cells) in a person’s blood
  • urine that’s darker than usual

Cholestasis of pregnancy can sometimes be hard for a pregnant woman to recognize. That’s because her growing belly can cause the skin to become itchy as it stretches. But itching related to the gallbladder is because bile acids that builds up in the blood can lead to intense itching.

Gallstones can cause the following symptoms. These attacks often occur after a high-fat meal and last about an hour:

  • jaundiced appearance
  • nausea
  • pain in the upper right or middle part of your stomach where your gallbladder is (it can be cramping, aching, dull, and/or sharp)

If the pain doesn’t go away in a few hours, this could indicate that something more severe is happening with your gallbladder.

Talking to your doctor about symptoms

Some pregnant women may develop gallstones without ever knowing about them. Known as “silent gallstones,” these don’t affect the gallbladder’s functions. But gallstones that do block the ducts where bile leaves can cause what’s known as a “gallbladder attack.” Sometimes these symptoms go away after an hour or two. Sometimes they persist.
If you experience the following symptoms that don’t go away after one to two hours, call your doctor and seek emergency medical attention:

  • chills and/or a low-grade fever
  • dark-colored urine
  • jaundiced appearance
  • light-colored stools
  • nausea and vomiting
  • stomach pain that lasts more than five hours

These are symptoms that a gallstone has led to inflammation and infection.

If you experience what you think may have been a gallbladder attack but your symptoms went away, it’s still important to get in touch with your doctor during regular business hours.

Your doctor may want to see you to ensure that all is well with your baby. Unfortunately, if you’ve had one gallbladder attack, the chances of having another are increased.

Treatments for gallbladder problems during pregnancy

Cholestasis of pregnancy treatments

A doctor can prescribe a medication called ursodeoxycholic acid (INN, BAN, AAN) or ursodiol (Actigall, Urso) to women with severe itching related to cholestasis of pregnancy.

At home, you can soak in lukewarm water (extremely hot water can be harmful to your baby) to reduce skin itching. Applying cold compresses could also help to reduce itching.

Note that some treatments you might normally use for skin itching, like an antihistamine or hydrocortisone cream, won’t help gallbladder-related skin itching. They could also harm your baby. During pregnancy, it’s best to avoid them.

There’s a greater risk for pregnancy complications with cholestasis of pregnancy, so a doctor may induce labor at the 37-week mark if the baby seems to be otherwise healthy.

Gallstone treatments

If a woman experiences gallstones that aren’t causing extreme symptoms and discomfort, a doctor will typically recommend watchful waiting. But gallstones that keep the bladder from emptying completely or cause an infection in the body may require surgery. Performing surgery during pregnancy isn’t a preferred treatment, but it’s possible a woman can safely have her gallbladder removed during pregnancy.

Gallbladder removal is the second most common nonobstetrical surgery during pregnancy. The most common is appendix removal.

Next steps

If you experience cholestasis of pregnancy, chances are you’ll have the condition if you become pregnant again. Anywhere from one-half to two-thirds of women who had cholestasis of pregnancy before will have it again.

Eating a healthy, low-fat diet during your pregnancy can reduce your risk for gallbladder symptoms. This can help keep you and your baby healthy. But always let your doctor know if you do have symptoms that involve your gallbladder. This allows your doctor to make the best plan for you and your baby.