Fetal gallstones are a rare occurrence.  They tend to occur in the third trimester. Their cause is unknown but may be related in some cases to maternal anemia or placental abruptions (1,2).  This author has seen four cases of fetal gallstones and three of the patients underwent amniocentesis. 

This present case was a late registration and it is unknown whether there was a placental hemorrhage earlier in the pregnancy.  The patient denies any vaginal bleeding during the course of the pregnancy and she was not anemic nor did she undergo amniocentesis.

Some fetal gallstones may disappear during the course of the pregnancy and others disappear shortly after delivery.  They may simply pass through the bile duct and into the duodenum or they may dissolve perhaps due to a difference in the chemical properties of fetal bile as compared to adult bile.

Fetal gallstones are a benign finding and pose no risk to the fetus or neonate.  It important to distinguish fetal gallstones from liver calcifications, since liver calcifications may herald the presence of an infection or tumor.