Vol 90, No 5 (2019)
Research paper
Published online: 2019-04-25

open access

Page views 2399
Article views/downloads 3374
Get Citation

Connect on Social Media

Connect on Social Media

Ophthalmological and obstetric management in pregnant women with retinal disorders

Joanna Moneta-Wielgos1, Michal Lipa2, Joanna Brydak-Godowska3, Marek Rekas1, Miroslaw Wielgos2
Pubmed: 31020991
Ginekol Pol 2019;90(5):285-288.

Abstract

Objectives: To analyze the clinical significance of ophthalmological assessment in pregnant women affected with degenerative retinal lesions, and the lesions’ clinical relevance in determining the obstetric management and delivery method. 

Material and methods: 69 pregnant women affected with retinal degenerative lesions were included in our study. In each patient, the risk of ophthalmological complications during vaginal delivery was evaluated. After the woman’s delivery, alignment between the ophthalmological recommendations and the obstetric management were analyzed. Each case where the management plan differed from the clinical proceedings was thoroughly investigated to determine the cause. 

Results: In 69 pregnant women the risk of ophthalmological complications was evaluated, and in 24 cases (35%) assessed as low, as medium in 37 cases (54%) and as high in 8 cases (11%). Among the 69 patients, 42 of women delivered vaginally and the remaining 27 underwent caesarean section. In the high-risk group, the rate of caesarean section was 87%, while in both the low- and medium-risk groups the rate of vaginal births was 75%. Two years of postnatal ophthalmological follow-up did not reveal any complications that could have been associated with the delivery. 

Conclusions: Every pregnant woman should undergo ophtalmological examination to assess peripartum risk of complications and determine the method of delivery. 

Article available in PDF format

View PDF Download PDF file

References

  1. Bruce A, O'Day J, McKay D, et al. Myopic degeneration: Pathological myopia. The Optician. 2007; 234(43).
  2. Landau D, Seelenfreund M, Tadmor O, et al. The effect of normal childbirth on eyes with abnormalities predisposing to rhegmatogenous retinal detachment. Graefe's Archive for Clinical and Experimental Ophthalmology. 1995; 233(9): 598–600.
  3. Dragoumis I, Richards A, Alexander P, et al. Retinal detachment in severe myopia. Lancet. 2017; 390(10090): 124.
  4. Dragoumis I, Richards A, Alexander P, et al. Retinal detachment in severe myopia. Lancet. 2017; 390(10090): 124.
  5. Konsensus okulistyczno-położniczy w sprawie wskazań do rozwiązania porodu drogą cięcia cesarskiego z powodu zmian w narządzie wzroku. Polskie Towarzystwo Okulistyczne Warszawa, 09. ; 02: 2017.
  6. Keep an eye on standardized management of laser refractive surgery under its rapid development. 2018; 54(10): 721–725.
  7. World Health Organization Human Reproduction Programme, 10 April 2015. WHO Statement on caesarean section rates. Reprod Health Matters. 2015; 23(45): 149–150.
  8. https://prog.nfz.gov.pl/app-jgp/Start.aspx.
  9. Spong CY, Berghella V, Wenstrom KD, et al. Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol. 2012; 120(5): 1181–1193.
  10. Groen RS, Trelles M, Caluwaerts S, et al. A cross-sectional study of indications for cesarean deliveries in Médecins Sans Frontières facilities across 17 countries. Int J Gynaecol Obstet. 2015; 129(3): 231–235.
  11. Pallasmaa N, Ekblad U, Aitokallio-Tallberg A, et al. Cesarean delivery in Finland: maternal complications and obstetric risk factors. Acta Obstet Gynecol Scand. 2010; 89(7): 896–902.
  12. Cantwell R, Clutton-Brock T, Cooper G, et al. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011; 118 Suppl 1: 1–203.
  13. Creanga AA, Bateman BT, Butwick AJ, et al. Morbidity associated with cesarean delivery in the United States: is placenta accreta an increasingly important contributor? Am J Obstet Gynecol. 2015; 213(3): 384.e1–384.11.
  14. Berthelot-Ricou A, Lacroze V, Courbiere B, et al. Respiratory distress syndrome after elective caesarean section in near term infants: a 5-year cohort study. J Matern Fetal Neonatal Med. 2013; 26(2): 176–182.