Changes in the gastrointestinal and hepatic systems
Gastric emptying is delayed in pregnancy due to reduced gastric secretions and gastric motility. The reduced motility is experienced in both the small and large bowel and colonic absorption of water and sodium is increased, contributing to increased rates of constipation in pregnancy.
The lower oesophageal sphincter may be displaced through the diaphragm and this combined with the increased intraabdominal pressure can contribute to increased heartburn experienced in pregnancy. In addition, this increases the risk of aspiration of gastric contents during induction of anaesthesia.The gallbladder increases in size and releases bile more slowly in pregnancy but the amount of bile excreted is unchanged. Increased progesterone concentrations reduce the levels of cholecystokinin and contractile response to cholecystokinin. Therefore, cholestasis is almost physiological in pregnancy but should not be high enough to cause jaundice.
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