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Review
. 2022 Dec;35(24):4755-4762.
doi: 10.1080/14767058.2020.1863366. Epub 2020 Dec 16.

The natural history of fetal gallstones: a case series and updated literature review

Marisa E Schwab  1   2 , Hillary J Braun  1   2 , Vickie A Feldstein  2   3 , Amar Nijagal  1   2
Affiliations
Review

The natural history of fetal gallstones: a case series and updated literature review

Marisa E Schwab et al. J Matern Fetal Neonatal Med. 2022 Dec.

Abstract

Introduction: The incidence of fetal gallstones is estimated at 0.45% and its clinical relevance after birth remains unknown. This study aimed to describe the natural history of fetal gallstones and their clinical sequelae after birth.

Methods: We queried a database of fetuses referred for second and third trimester sonograms performed for high-risk pregnancies, and identified cases with fetal gallstones (1996-2019). Demographics, prenatal/postnatal imaging findings, and clinical sequelae were collected. A literature review was performed according to PRISMA guidelines.

Results: We screened approximately 200,000 obstetric sonograms; 34 fetuses were found to have cholelithiasis. The median gestational age at the time of sonogram was 35 weeks (range 22-38). Fifty-six percent were female and 11.8% were twin pregnancies with one affected fetus. Median maternal age was 28 years (range 17-42). Eight fetuses underwent postnatal imaging and 4 had persistent cholelithiasis. There was one case of in utero demise. Two patients had structural anomalies (renal and cardiac) by sonogram. A subset of 17 patients was followed long-term (range 3-20 years), and none developed clinical sequelae from cholelithiasis.

Discussion/conclusions: No child developed postnatal clinical sequelae related to cholelithiasis identified in utero. Fetal cholelithiasis can be managed expectantly without follow-up imaging in asymptomatic patients.

Keywords: Fetal gallstones; cholelithiasis; prenatal ultrasound.

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Conflict of interest statement

Disclosure of interest

The authors report no conflict of interest.

Figures

Fig. 1.
Fig. 1.
PRISMA flow diagram
See this image and copyright information in PMC

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