Delivery recommendations for pregnant females with risk factors for rhegmatogenous retinal detachment

Chiu, Houn-Lin; Steele, Donna; McAlister, Chryssa; Lam, Wai Ching

doi:10.1016/j.jcjo.2014.10.015

Cited by 14 publications

(25 citation statements)

References 9 publications

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“…Although C-section delivery is recommended for the purpose of early pregnancy termination in specific clinical situations, it has no proven advantage over NVD for term delivery. With regular ophthalmic examinations during pregnancy (every three months), we argue that eye diseases are not an indication for C-section delivery at term 10, 41, 49. This is in overall agreement with the previously published surveys.…”

Section: Discussionmentioning

confidence: 86%

“…Chiu and colleagues conducted a survey in 2015 among ophthalmologists and obstetrician-gynecologists on the mode of delivery in women with risk factors for rhegmatogenous retinal detachment including myopia. Thirty-four percent of obstetrician-gynecologists recommended C-section or instrumental delivery compared to only 4% of ophthalmologists 41 . This high degree of consensus among ophthalmologists may act as a reference expert opinion till empiric evidence is made available.…”

Section: Discussionmentioning

confidence: 98%

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A survey of ophthalmologists and gynecologists regarding termination of pregnancy and choice of delivery mode in the presence of eye diseases

Mohammadi

Letafatnejad

Ashrafi

et al. 2017

Journal of Current Ophthalmology

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PurposeTo evaluate and compare the attitudes of ophthalmologists and gynecologists in suggesting appropriate approach to pregnancy in different ocular conditions.MethodsSpecialty-specific questionnaires on delivery mode and abortion indications for ophthalmic patients (refractive, vascular, oncologic, retinal, glaucoma, postoperation, posttrauma, and infectious) were designed and distributed among physician staff of Farabi Eye Hospital and Yas Women Hospital in Tehran. Attitudes and preferences of the ophthalmologists and gynecologists were quantified and compared.ResultsParticipants were 29 ophthalmologists and 19 gynecologists. Their mean age was 49.73 ± 7.57 and 46.79 ± 1.36 years, respectively. More than 50–70% ophthalmologists were in favor of normal vaginal delivery (NVD) in all ocular diseases. All gynecologists (100%) expressed their need for an ophthalmologist's opinion for decision-making. Ophthalmologists' top choices for conditions potentially requiring a caesarean section were corneal transplants (34.5%), high myopia (23%), retinal detachment (29%), and orbital tumors (34.5%), while two gynecologists recommended abortion in the presence of intraocular and orbital tumors and retinal detachment.In the case of a history of refractive surgery, orbital tumor and intraocular tumor, ophthalmologists recommend NVD over caesarean section twice as much as their gynecologist peers. For history of retinal detachment, glaucoma, retinal vascular accident and intraocular hemorrhage, no single gynecologist recommend NVD. The corresponding figure for ophthalmologist-recommended NVD were 67, 84, 72, and 81%.ConclusionsThere is extreme inconsistency among ophthalmologists and gynecologists in managing ophthalmic-obstetric scenarios, especially for caesarean section indications. Clinical guideline development and consultation for decision-making in challenging cases are recommended.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 98%

A survey of ophthalmologists and gynecologists regarding termination of pregnancy and choice of delivery mode in the presence of eye diseases

Mohammadi

Letafatnejad

Ashrafi

et al. 2017

Journal of Current Ophthalmology

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“…[39][40][41][42][43][44] It should be avoided in the first trimester and in the puerperium if the baby is undergoing phototherapy (a relevant concentration in the breast milk is detected, with published cases of phototoxicity associated with fluorescein). 45 Indocyanine green was administered to pregnant women with non-ophthalmologic purposes (such as for the measurement of the hepatic flow), without adverse effects on the mother or fetus. 38 It does not cross the placenta, and it is unknown if it is present in the breast milk.…”

Section: Diagnostic Agentsmentioning

confidence: 99%

Ocular Changes During Pregnancy

Marcos-Figueiredo

Menéres

et al. 2017

Rev Bras Ginecol Obstet

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Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of the mode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.

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“…This is of particular concern to clinicians if the woman has a history of RD or is known to be at risk for RD due to high myopia, peripheral retinal degeneration or previous treatment for a retinal tear. This has led some obstetricians to advocate for assisted delivery or for referring the patient to ophthalmology for advice regarding mode of delivery …”

Section: Introductionmentioning

confidence: 99%