Perception and practices of obstetricians and ophthalmologists eye diseases during pregnancy

Abstract

Aims: Cesarean delivery can be crucial for both the mother and the baby, with indications often stemming from fetal or maternal health concerns. In addition to obstetric factors, non-obstetric conditions such as eye diseases frequently necessitate cesarean delivery. Among the eye diseases commonly encountered during pregnancy are refractive errors, diabetic retinopathy, ocular malignancies, and glaucoma. Some of these conditions may exacerbate during pregnancy due to related health issues like diabetes or hypertension, or they may be aggravated by the stress of vaginal labor. Consequently, the decision regarding the continuation of pregnancy, the mode of delivery, and even the choice of anesthesia can vary depending on the specific eye disease and its severity or characteristics. The aim of this study was to assess the knowledge and attitudes of obstetricians regarding the management of pregnant women with different eye conditions, with the ultimate goal of increasing awareness among obstetricians. Methods: In this study, a total of 46 obstetricians and 30 ophthalmologists practicing in Turkiye were included. Participants were surveyed to gather information, as no existing survey or scale pertaining to our study subject was available. Therefore, a novel survey form was developed based on previous studies addressing similar topics, and this survey was administered to all participants. Results: During the study, both obstetricians and ophthalmologists were queried about the management of 17 distinct eye diseases occurring during pregnancy. Ophthalmologists advocated for normal vaginal delivery (NVD) in 13 out of the 17 eye diseases. On the other hand, obstetricians opted for NVD in 5 out of the 17 cases, while recommending ophthalmology consultation in 12 out of the 17 scenarios. Conclusion: It has been noted that ophthalmologists suggest vaginal birth in 9 out of 17 eye diseases, whereas obstetricians tend to recommend consulting ophthalmologists rather than making independent decisions. This trend may stem from the fact that obstetricians may lack sufficient knowledge about eye diseases, as these conditions are not primarily within the scope of pregnancy-related care. Additionally, obstetricians might be inclined to share responsibility, possibly due to the rise in malpractice cases against obstetricians in recent years in Turkiye.