FUNDUS CHANGES IN PREGNANCY INDUCED HYPERTENSION

Abstract

Pregnancy induced hypertension (PIH) is a hypertensive disorder in pregnancy that occurs in the absence of other causes of elevated blood pressure (140/90mmHg), along with generalized edema and/or proteinuria. To PURPOSE: determine the prevalence of retinal changes in pregnancy induced hypertension & association between retinal changes and blood pressure, proteinuria, severity of disease. SUBJECTS AND METHODS: This cross sectional, observational study was conducted over a period of eight months (January to August 20021). All the patients who fullled the diagnostic criteria of PIH (>24 weeks of pregnancy, high arterial blood pressure and proteinuria) admitted in Obstetrics and Gynaecology ward, Government General Hospital, Kurnool were included. Exclusion criteria: Patients who had pre-existing diabetes or hypertension or renal disease or hazy media which did not permit fundus examination were excluded from the study. After taking history for any eye symptoms, anterior segment was examined with torch light on the bed itself. Both pupils were dilated with 1% tropicamide eye drops and fundus examination was done with direct ophthalmoscope in a semi dark room in the ward. Hypertensive retinopathy changes seen in right or left or both eyes, were taken as positive ndings in that patient. Age, race, gravida, para, blood pressure, proteinuria were noted from the case records. PIH was graded as preeclampsia (mild and severe) and eclampsia. All the ndings were noted on a data sheet. RESULTS: A total of 30 patients were examined. The mean age of patients was 30 years (range 21-45 years). The gestation period ranged between 25 and 40 weeks. 18 were primi gravida, 8 were multi gravida and 4 were grand multis. Among them 22 had mild preeclampsia, 6 had severe preeclampsia and 2 had eclampsia. Blurring of vision was present in two patients of severe preeclampsia and visual acuity was 6/9 in both eyes in both patients and 6/12 in both eyes in one patient of eclampsia. Visual acuity was normal (6/6 in both eyes) in 27 patients. Retinal changes (hypertensive retinopathy) were noted in 16 (53%) patients.