CHOLELITHIASIS IN PREGNANCY: DIAGNOSTIC AND THERAPEUTIC CHALLENGES

Abstract

Cholelithiasis during pregnancy is a clinical condition of significant importance due to its increased prevalence among women of childbearing age and the physiological changes characteristic of the gestational period that favor the formation of gallstones. This study, through an integrative literature review, aimed to analyze the main diagnostic and therapeutic challenges associated with cholelithiasis in pregnant women. The research was conducted in the PubMed, SciELO, LILACS and Scopus databases, covering publications between 2013 and 2024. The results revealed that the signs and symptoms of cholelithiasis can be confused with common manifestations of pregnancy, making clinical diagnosis difficult. Abdominal ultrasound is the most commonly used imaging method, although its accuracy may be reduced in advanced stages of pregnancy. Regarding treatment, initial conservative management is preferred in uncomplicated cases, with videolaparoscopic cholecystectomy indicated when there is therapeutic failure or complications. The second trimester is considered the safest period for surgery. The absence of standardized clinical protocols and the scarcity of randomized studies reinforce the need for individualized approaches and multidisciplinary action. It is concluded that the approach to cholelithiasis during pregnancy requires evidence-based clinical strategies, focusing on maternal-fetal safety and therapeutic efficacy.