After acute appendicitis, gallbladder problems are the most common nonobstetric condition requiring surgery during pregnancy. All pregnant women with cholecystitis and troublesome gallstones should be closely followed as attacks tend to recur during the pregnancy. This is the most common peculiar condition and second to viral hepatitis as a cause of jaundice in pregnancy. Early diagnosis and timed intervention can improve the outcome for the baby. Jaundice develops two to four weeks later but may not be obvious.
Symptoms resolve rapidly after delivery.
Women with intrahepatic cholestasis of pregnancy, those with known family members affected or jaundice exacerbated by oral contraceptive pills should be followed closely throughout pregnancy. Some women require supplements of vitamins, particularly vitamin K1 to replace excess loss in their stools. Maternal outcome is good. Itching and jaundice resolve rapidly but may recur in other pregnancies and oestrogens. Many treatments have been tried to relieve the itching but should be carefully monitored during pregnancy.