Careful assessment allowed us to localize the echogenic foci within fetal gallbladder. Correct identification of fetal gallstones allows for adequate counseling and avoids unnecessary work-up and maternal anxiety. The natural history of fetal gallstones seems to be very different from that of children and adults. Gallstones in adults and children grow at about 1 to 2 mm per year, occurring many years before clinical symptoms appear. Gallstones do not continually form in the gallbladder but probably nucleate as crops of stones that then grow at the same rate 5 .
Most gallstones are clinically silent.
Gallbladder motility decreases once stones develop. Some, but not all, patients with cholelithiasis have impaired gallbladder emptying 5 . Fetal gallstones have a tendency to form in the third trimester of pregnancy. We observed gallstones in a 26 week fetus, which represents the earliest reported case in the literature. The fact that we were able to detect gallstones in the bile ducts may favor the first hypothesis in which fetal gallstones are passed.