A pregnant woman under your care complains of indigestion, belching, flatulence, and upper right quadrant cramping pain that "comes and goes." What diagnostic test should be ordered?
A. Gall bladder HIDA scan
B. Ultrasound of the gall bladder
C. Abdominal CT scan
D. Upper endoscopy
ANS: B
Pregnancy increases the risk of developing gallstones, owing to an increased progesterone level that reduces gallbladder emptying and therefore increases biliary stasis. Subsequent pregnancies exponentially increase the risk of cholelithiasis. Gallstones occur in approximately 7% of nulliparous women and 19% of multiparous women (Parangi & Pories, 2007). If radiology studies are warranted, ultrasound is safe and effective in diagnosing intra-abdominal conditions during pregnancy. Current knowledge indicates that magnetic resonance imaging (MRI) is safe during pregnancy, but computed tomography (CT) scans expose the fetus to doses of ionizing radiation (Sakornbut, 2008a). HIDA scan is a nuclear diagnostic test that involves x-rays. Although upper endoscopy is not dangerous during pregnancy, it is preferred to not perform invasive testing during pregnancy.
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