A retrospective study of association of fundal changes and foetal outcome in preeclampsia and eclampsia

H Savitha, C Sanjay Kumar, S Sowmya
2015 MedPulse-International Medical Journal August   unpublished
Aim: To determine the prevalence of retinal changes in pregnancy induced hypertension (PIH) and any association between the retinal changes, blood pressure, proteinuria, severity of the disease. Methods: All the patients admitted with diagnosis of PIH were included in this study. Age, gravida, gestation period, blood pressure, and proteinuria were noted from the case records. After taking history for any eye symptoms, fundus examination was done after dilating the pupils with direct
more » ... direct ophthalmoscope in the ward itself. All the findings were noted on a data sheet, and were analyzed using SPSS programme. Results: A total of 100 patients of PIH were examined. The mean age of patients was 24 years (range 18-38 years). 97% had preeclampsia and 3% had eclampsia. Retinal changes (hypertensive retinopathy) were noted in 17% patients-grade I in 11 (64%) and grade II in 6 (35%). Haemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant association of retinal changes, blood pressure (=0.001), serum uric acid (=0.003) ,birth weight (=<0.001), Apgar Score at 1minute of birth (=0.004). Conclusion: Retinal changes (grade I and II hypertensive retinopathy) were seen in 17% of patients with PIH and they were significantly associated with blood pressure, serum uric acid levels. Fetal outcome is poor in those with fundal changes. Fundus examination helps in assessing the severity of PIH and helps in timely management.