open access

Vol 87, No 3 (2016)
Review paper
Published online: 2016-04-13
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Cesarean section and eye disorders

Izabella Karska-Basta, Marta Tarasiewicz, Agnieszka Kubicka-Trząska, Joanna Miniewicz, Bożena Romanowska-Dixon
DOI: 10.17772/gp/61752
·
Pubmed: 27306132
·
Ginekol Pol 2016;87(3):217-221.

open access

Vol 87, No 3 (2016)
REVIEW PAPERS Obstetrics
Published online: 2016-04-13

Abstract

Recently, a growing tendency for cesarean birth has been noted both, in Poland and worldwide. Non-obstetric problems constitute a large part of indications for cesarean section. Many ophthalmologists and obstetricians still believe that high myopia, the presence of peripheral retinal degenerations, history of retinal detachment surgery, diabetic retinopathy, or glaucoma are indications for surgical termination of pregnancy. However, these recommendations are not evidence-based. The literature offers no proof that high myopia and previous retinal surgery increase the risk of retinal detachment during spontaneous vaginal delivery. There is only one indication for cesarean section in myopic patients, i.e. the presence of choroidal neovascularization, which can cause subretinal bleeding with acute visual loss. Prolonged and intensified Valsalva maneuver during labor in patients with an active proliferative diabetic retinopathy may be an indication for an elective cesarean section. Uterine contractions during the second stage of vaginal delivery lead to a marked elevation of intraocular pressure. Intraocular pressure fluctuations during the delivery may damage retinal ganglion cells, resulting in further progression of visual field.

Thus, glaucoma associated with advanced visual field changes is the next ophthalmic indication for cesarean section.

The report presents the current state of knowledge concerning the effect of pregnancy on pre-existing ocular disorders and the influence of physiological changes on the clinical course of these diseases during the stages of natural delivery. The authors discuss also the ophthalmic indications for cesarean section.  

Abstract

Recently, a growing tendency for cesarean birth has been noted both, in Poland and worldwide. Non-obstetric problems constitute a large part of indications for cesarean section. Many ophthalmologists and obstetricians still believe that high myopia, the presence of peripheral retinal degenerations, history of retinal detachment surgery, diabetic retinopathy, or glaucoma are indications for surgical termination of pregnancy. However, these recommendations are not evidence-based. The literature offers no proof that high myopia and previous retinal surgery increase the risk of retinal detachment during spontaneous vaginal delivery. There is only one indication for cesarean section in myopic patients, i.e. the presence of choroidal neovascularization, which can cause subretinal bleeding with acute visual loss. Prolonged and intensified Valsalva maneuver during labor in patients with an active proliferative diabetic retinopathy may be an indication for an elective cesarean section. Uterine contractions during the second stage of vaginal delivery lead to a marked elevation of intraocular pressure. Intraocular pressure fluctuations during the delivery may damage retinal ganglion cells, resulting in further progression of visual field.

Thus, glaucoma associated with advanced visual field changes is the next ophthalmic indication for cesarean section.

The report presents the current state of knowledge concerning the effect of pregnancy on pre-existing ocular disorders and the influence of physiological changes on the clinical course of these diseases during the stages of natural delivery. The authors discuss also the ophthalmic indications for cesarean section.  

Get Citation
About this article
Title

Cesarean section and eye disorders

Journal

Ginekologia Polska

Issue

Vol 87, No 3 (2016)

Article type

Review paper

Pages

217-221

Published online

2016-04-13

Page views

5242

Article views/downloads

8973

DOI

10.17772/gp/61752

Pubmed

27306132

Bibliographic record

Ginekol Pol 2016;87(3):217-221.

Authors

Izabella Karska-Basta
Marta Tarasiewicz
Agnieszka Kubicka-Trząska
Joanna Miniewicz
Bożena Romanowska-Dixon

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