Tsimoyiannis E C, Antoniou N C, Tsaboulas C, Papanikolaou N
Department of Surgery, Hatzikosta General Hospital, Ioannina, Greece.
Eur J Surg. 1994 Nov;160(11):627-31.
To assess the incidence of formation of gallstones during pregnancy and lactation, the time when gallstones first appear, and any changes in predisposing factors.
Prospective study.
District hospital, Greece.
669 pregnant women seen between 1988 and 1991.
Body mass index (kg/m2); real time ultrasonography; and measurements of serum concentrations of bilirubin, total cholesterol, low density lipoprotein cholesterol, and triglycerides, and of activities of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and amylase. All measurements were made at the beginning of pregnancy; at the third, sixth and ninth months; and 7 days and 6 months after delivery.
6 women (1%) mean age 26 years, had pre-existent gallstones and 14 further women (2%) mean age 27 years, developed gallstones; 13 were discovered during pregnancy (8 during the second trimester, and 5 during the third) and one during lactation. Women who had 3 or more pregnancies (6/110, 5%) were significantly more likely to develop gallstones than those who had not been pregnant before (3/304, 1%, p = 0.01). Gallbladder volume more than doubled during pregnancy from a mean (SD) of 12 (4) to 26 (4) ml. Total cholesterol, low density lipoprotein cholesterol and triglyceride concentrations, and alkaline phosphatase activity increased gradually, and reverted to the value found at the beginning of pregnancy immediately after delivery.
The risk of developing gallstones increased with the number of pregnancies, and most of the stones developed during the second or third trimester.
评估妊娠和哺乳期胆结石形成的发生率、胆结石首次出现的时间以及诱发因素的任何变化。
前瞻性研究。
希腊地区医院。
1988年至1991年间就诊的669名孕妇。
体重指数（kg/m²）；实时超声检查；以及血清胆红素、总胆固醇、低密度脂蛋白胆固醇和甘油三酯浓度的测定，以及丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶和淀粉酶活性的测定。所有测量均在妊娠开始时、妊娠第三个月、第六个月和第九个月以及分娩后7天和6个月进行。
6名女性（1%）平均年龄26岁，孕前有胆结石，另有14名女性（2%）平均年龄27岁，患上胆结石；13例在孕期发现（孕中期8例，孕晚期5例），1例在哺乳期发现。有3次或更多次妊娠的女性（6/110，5%）比从未怀孕的女性（3/304，1%，p = 0.01）患胆结石的可能性显著更高。孕期胆囊体积从平均（标准差）12（4）ml增加到26（4）ml，增加了一倍多。总胆固醇、低密度脂蛋白胆固醇和甘油三酯浓度以及碱性磷酸酶活性逐渐升高，分娩后立即恢复到妊娠开始时的水平。
患胆结石的风险随着妊娠次数的增加而增加，大多数结石在孕中期或孕晚期形成。
