FUNDUS CHANGES IN PRE-ECLAMPSIA AND ECLAMPSIA- AN OBSERVATIONAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 3
Abstract
BACKGROUND Pre-eclampsia is reported to occur in around 25% of primigravida and 12% - 15% of subsequent pregnancies. Ocular involvement is common. Reversible cortical blindness and extraocular muscle palsy have also been documented in eclamptic patients. The ocular vascular changes have been said to correlate with the severity of hypertension and this has been used as an indicator for termination of pregnancy. The aim of this study is to determine the retinal changes in pre-eclampsia and eclampsia, and its relationship with severity of hypertension. MATERIALS AND METHODS An observational study was conducted over the period of 9 months at Department of Ophthalmology, Madurai Medical College among 199 patients, who fit into the diagnostic criteria of pre-eclampsia and eclampsia. After obtaining a detailed history, a thorough ocular examination was conducted with necessary blood investigations. All subjects were reviewed again at Ophthalmology Department two weeks after delivery. RESULTS The information collected regarding all the cases were recorded in a Master Chart. The study subjects were segregated into three major groups- Group 1: Mild Pre-eclampsia - BP > 140/90 mmHg with proteinuria > 300 mg/mL; Group 2: Severe pre-eclampsia - BP > 160/110 mmHg with proteinuria > 500 mg/mL associated with elevated renal parameters/ pulmonary oedema/ HELLP syndrome/ foetal compromise; and Group 3: Eclampsia- any unexplained seizures/ coma. The eclampsia group had more number of aged mothers, primigravida with generalised and pedal oedema and also proteinuria, whereas mothers with severe preeclampsia and mild pre-eclampsia were in the lower age group with or without pedal oedema and proteinuria, and the visual acuity was found to improve in all the three groups after delivery. CONCLUSION The frequency and severity of fundus changes more closely follow the severity of hypertension and also an associated early onset of pre-eclampsia by 24 - 28 weeks of pregnancy. Most of the patients with grade 1 and grade 2 fundus changes had an uncomplicated mode of delivery with a good foetal outcome and fundus findings resolved after delivery.
Authors and Affiliations
Karupputhevar Senthil, Sivasamy Subhashankari, Ganesan Vidhubala, Manoharan Suhanya, Pugaledndhi Priyadharsini, Bohar Sugapriya, Sanjayraut Ashwini
Keywords
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- EP ID EP284625
- DOI 10.14260/jemds/2018/64
- Views 77
- Downloads 0
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