Maternal gallbladder assessment during obstetric ultrasound: results, significance, and technique.

BACKGROUND: Gallbladder disease is four times as common in women as in men, and pregnancy appears to contribute to the development of gallstones. During pregnancy, most women receive ultrasound scans, which are highly sensitive to the detection of gallstones. The purpose of this study was to examine the additional time and effort required to scan the gallbladder during obstetric ultrasound scanning.
METHODS: The maternal gallbladder was examined in 228 consecutive obstetric ultrasound scans performed for medical indications at any time during pregnancy. Scanning was conducted by family physician faculty located in two university settings and one rural private practice. Patients were not required to fast prior to the scan.
RESULTS: Gallstones were found in 5.3% of the patients, and an additional 3.1% had undergone prior cholecystectomy, for an overall incidence of current or previous gallbladder disease among 8.4% of the patients. The gallbladder was visualized in 97.4% of patients without a previous cholecystectomy. In 95.7% of cases, obtaining this additional information required less than 2 minutes.
CONCLUSIONS: This study suggests that an evaluation of the maternal gallbladder at the time of obstetric ultrasound scans can be performed rapidly without special patient preparation. The study further suggests that obstetric ultrasound skills may allow family physicians to expand their diagnostic use of ultrasound to include gallbladder evaluation. Scanning techniques and the clinical significance of having this information in the patient's medical record are discussed.