Fundus Changes in Pregnancy-Induced Hypertension

Abstract

BACKGROUND:
In both industrialized and developing nations, hypertensive problems during pregnancy are regarded as the main cause of maternal morbidity and mortality. It affects 7 to 10% of all pregnancies and is the most frequent medical issue during pregnancy. Differentiating between hypertension caused by pregnancy and hypertension unrelated to pregnancy is the major challenge for clinicians. Anything along the visual system, from the anterior segment to the visual cortex, might be affected by pregnancy. Almost every organ system in the body is impacted by PIH, including the ophthalmic, cardiovascular, renal, endocrine, and central neurological systems. Vasospastic alterations can be reversed, and following delivery, vasospasm in the retinal vessels returns to normal. Severe toxemia causes involvement of the visual system.
OBJECTIVE: The objective of this research was to ascertain the frequency of retinal changes in pregnancy-induced hypertension (PIH) and any relationships between the retinal changes and proteinuria, blood pressure, and illness severity.
MATERIAL AND METHOD:
This ophthalmology department observational cross-sectional study was conducted. The study included all pregnant women between the ages of 18 and 35 who visited the OPD and were admitted to the hospital's obstetric ward and had systolic blood pressure of more than 140 mm Hg and diastolic blood pressure of more than 90 mm Hg. For 100 cases of PIH with a diagnosis, the study was undertaken. Individuals with preexisting renal illness, diabetes, hypertension, or hazy media that prevented fundus visualization were excluded from the study.
RESULTS:
100 patients underwent examination; 65% of PIH cases were discovered in the 21–25 age range. The patients' average age was 23.22 2.2 years. 40% of women were multi-gravida, 60% were primi-gravida. 70% of patients with moderate preeclampsia, 25% with severe preeclampsia, and 5% with eclampsia. 65% of individuals had hypertensive retinopathy, whereas the other 35% had normal fundi. As the patient's hypertension becomes more severe, the likelihood of aberrant fundus findings increases. Results from the fundus and parity were contrasted. Hence, there was no association between the fundus findings and parity.
CONCLUSION:
In all situations of pregnancy-induced hypertension, a retinal examination is essential. It is a key factor in deciding whether to end a pregnancy because it is a sign of how severe the fundus finding and hypertension are. A fundus examination is a crucial clinical assessment for PIH patients to anticipate unfavorable fetal outcomes as well as the risk to the mother's life.
KEYWORDS: Pregnancy Induced Hypertension; Retinal Changes; Preeclampsia; Eclampsia and Cortical Blindness