Abstract
Discussion Forum (0)
Introduction:
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Introduction:
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Symptomatic Cholelithiasis in Pregnancy: Management Options and Pregnancy Outcomes
Dr. Nathan Pray
Abstract
Discussion Forum (0)
Introduction:
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Introduction:
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
Symptomatic cholelithiasis and cholecystitis are two of the more common diagnoses in pregnancy which may require surgical intervention. However, the optimal management of these patients is uncertain, with some patients being managed medically and others surgically. The purpose of this study was to identify the trends in management of symptomatic cholelithiasis and cholecystitis based on presenting characteristics as well as report the pregnancy outcome in each group.
Methods:
A 12-year retrospective cohort study was performed. Symptomatic pregnant patients with ultrasound findings suggestive of cholelithiasis or acute cholecystitis were grouped based on whether they underwent medical versus surgical management and clinical characteristics at presentation and pregnancy outcomes were evaluated.
RESULTS:
Surgical management was associated with earlier estimated gestational age (EGA) at time of diagnosis (p = 0.018) and inversely associated with increasing body mass index (p = 0.037). The EGA at delivery was similar in both groups, though patients managed surgically had a median birth weight 289g lower than those managed surgically and more neonates weighing < 3000 gm. Meconium was more prevalent in the medically managed group (39% vs. 6%, p=0.041). There was a 24% rate of pregnancy associated hypertensive disorders.
Conclusion:
Optimal management for symptomatic cholelithiasis/cholecystitis in pregnancy remains uncertain, though heavier patients and those at later gestational ages were more likely to be managed medically. Both cohorts had similar good outcomes, however the nearly doubled risk for hypertensive disorders for these patients may warrant closer monitoring.
{{ help_message }}
{{filter}}