Association between pregnancy-induced hypertensive fundus changes and fetal outcomes

Abstract

Background: Ocular involvement in pregnancy-induced hypertension (PIH) is common.Objective: To study the association between pregnancy-induced hypertensive fundus changes and fetal outcomes. Subjects and methods:A prospective cohort study was carried out including 153 subjects with the diagnosis of PIH. The subjects were evaluated for hypertensive fundus changes. Fetal outcomes were assessed in terms of gestational age, birth weight, 1 minute Apgar score, stillbirth and neonatal death. Statistics:The chi 2 test was used to evaluate the association between the various fundus changes and fetal outcomes using SPSS version 10 software program.Results: Fundus changes were found in 13.7 % of the subjects. The means of systolic and diastolic BP of the subjects with hypertensive fundus changes were 182.86 ± 33.64 and 125.24 ± 21.36 respectively, whereas those values without fundus changes were 150.72 ± 12.86 and 100.07 ± 9.51.Vitreous hemorrhage, serous retinal detachment and macular star were not found in this study. Fetal outcomes in PIH patients with vascular changes alone were similar to those with no fundus changes. Retinal and optic nerve head changes were found to be associated (p =0.016) with low birth weight (<2.5 kg). Choroidal changes and optic nerve head changes were associated with low Apgar score. Conclusion:Retinal and optic nerve head changes are associated with low birth weight. Choroidal changes and optic nerve head changes are associated with low Apgar score. Fundus evaluation in patients with PIH is an important procedure to predict adverse fetal outcomes.

Prevalence of Hypertensive Retinopathy Changes in Pregnancy induced Hypertension

“…Most common ocular finding is severe arteriolar spa-sm [3], evidenced by either segmental or gene-ralized constriction of retinal arterioles (Wagner represented spastic lesion of retinal arteriole in 70% of PIH) [18]. The prevalence of HTN retinopathy [15] changes 42(27.27%) in our study showed significant association with severity of preeclampsia(p=0.0001) similar to Reddy et al [16].…”

“…Tadin et al [13] a study of 40 women with preeclampsia, 45% showed abn-ormalities.The average age of 40 patients was 29.1 years.In another study by Jaffe and Schatz, mean age of the patient was 28 years [14]. Preeclampsia a disease of 1 st pregnancy 16-25% and 12-15% of subsequent pregnancies [15].…”

Association between ophthalmoscopic changes and obstetric outcomes in pre-eclampsia and eclampsia

“…16 In our study also, the incidence of low birth weight, low Apgar score and NICU admission rate were significantly higher in the mothers having fundoscopic changes compared to those without changes.…”

Ophthalmic Complications and Ocular Changes in Pregnancy- A Review

“…Severe retinopathy with rapidly progressing arteriospasm denotes a compromise in the maternal circulation [19]. Choroidal and optic nerve head changes are also associated with low birth weight and low Apgar scores [23]. Therefore in order to increase fetal prognosis, caesarian delivery may be indicated.…”

“…Retinal changes are correlated with the severity of preeclampsia or eclampsia [22]. Choroidal and optic nerve head changes are also associated with low birth weight and low Apgar scores [23]. Therefore, fundus evaluation in patients with pregnancy induced hypertension is an important procedure to help predict adverse fetal outcomes [24].…”