Retinal Changes in Pregnancy Induced-Hypertension

Zade, Mandar; Veeramani, V. Panimalar A.; Divya, N; Bhaskaran, Bindu

doi:10.22159/ijcpr.2021v13i1.40797

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…In our study, severe hypertension was associated with retinopathy among women with hypertensive disorders of pregnancy. This finding is similar to what was reported in others studies 14 15 18 21 24. The retinal changes observed may be due to constriction of the retinal arterioles which occurs following the elevation of blood pressure 15.…”

Section: Discussionsupporting

confidence: 92%

Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study

Zamaladi,

Ruvuma,

Mceniery

et al. 2023

BMJ Open

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ObjectiveRetinopathy is one of the complications occurring among women with hypertensive disorders of pregnancy. We sought to determine the prevalence and factors associated with retinopathy among women with hypertensive disorders of pregnancy in southwestern Uganda.DesignThis was a hospital-based cross-sectional study from November 2019 to March 2020.SettingThree selected hospitals in Mbarara city, south-western Uganda.ParticipantsThe study included all pregnant women with hypertensive disorders of pregnancy.Primary and secondary outcome measuresThe participants were screened for retinopathy using a fundus camera. Data on participant’s sociodemographics, obstetrics and medical factors were collected. The prevalence of retinopathy was determined and multivariable logistic regression was used to determine the independent factors associated with retinopathy.ResultsA total of 216 women with hypertensive disorders of pregnancy were enrolled in this study. The prevalence of retinopathy was 60.2% (130/216). The most common retinal lesions were grade 1 retinopathy (narrowing of arterioles) accounting for 86.9% (113/130), grade 3 (retinal haemorrhages) was present in 10% (13/130) of women and grade 4 (papilloedema) in 3% (4/130). In an adjusted analysis, severe hypertension was significantly associated with retinopathy (aOR=2.8; 95% CI: 1.36 to 5.68). Grandmultigravida women were also associated with retinopathy (aOR=2.4; 95% CI: 0.99 to 5.72) with a tendency towards significancy, p=0.051.ConclusionsIn our study, retinopathy was common among women with hypertensive disorders of pregnancy. Women presenting with severe hypertension were likely to have retinopathy. There is a need to integrate screening for retinopathy in the care cascade of women with hypertensive disorders of pregnancy.

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Section: Discussionsupporting

confidence: 92%

Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study

Zamaladi,

Ruvuma,

Mceniery

et al. 2023

BMJ Open

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“…This is comparative to study done by Nathe et al showed among 23 patients with BP>160/100mmHg, 10 developed retinopathy. [11] In our study 2 cases (4.1%) present with papilledema. Exudative retinal detachment is rare in PIH.…”

Section: Discussionsupporting

confidence: 49%

“…Pregnancy-induced hypertension is the most frequent complication in pregnancy, increases the risk of mortality and morbidity for both the mother and the foetus. [2] According to WHO, 14% of maternal death are caused by hypertensive disorders in pregnancy. [3] Five to ten percent of pregnancies are complicated by hypertensive disorders.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Induced Hypertension and Retinopathy

Aishwarya

Manavalan

2023

Int J Res Rev

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AIM AND OBJECTIVES: The aim of this study is to determine the prevalence of retinal changes in pregnancy induced hypertension and to find out its association with severity of hypertension and proteinuria. MATERIAL AND METHODS: A total of 94 pregnant females presented with pregnancy induced hypertension were included in this study. Patients with pre-existing hypertension, coexisting diabetes mellitus, severe anemia, connective tissue disorders were excluded from the study. Detailed fundus examination done and results were interpreted. OBSERVATION: Out of 94 patients with pregnancy induced hypertension, 41.5% belongs to 26-28 years of age.59.65 were primigravida. Headache was common complaint with 27.6% followed by blurred vision. Among the participants, 52.1% having systolic blood pressure of 150 to 159mmHg presented with fundus changes and 45.8% having diastolic pressure of more than 110mmHg presented fundus finding. In fundus finding, 51.0% presented with hypertensive retinopathy. Among hypertensive retinopathy, 43.8% cases were Grade I, 39.6% cases were Grade II, 12.5%cases were Grade III,4.1% cases were Grade IV.Grade I and Grade II found to be common. Our study shows statistically significant relationship with severity of hypertension and retinal changes (p<0.05) CONCLUSION: The study concluded that there is a positive correlation of fundus changes with severity of hypertension and grades of proteinuria. There is positive association with severity of hypertension, blood urea levels, serum uric acid level. So regular ophthalmic examination is mandatory in assessing the vascular changes in retina and helps in follow up the patients postpartum to prevent the complications. Keywords: Pregnancy induced hypertension, Hypertensive retinopathy, proteinuria..

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Retinal Microvascular Characteristics and Outcomes in Hypertensive Disorders of Pregnancy.

Wali,

Mudanur,

Kuruvila

et al. 2024

Cureus

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Background Hypertensive disorders of pregnancy (HDP) is a continuum of chronic hypertension, gestational hypertension, preeclampsia, and eclampsia in increasing severity, associated with a higher risk of complicated pregnancies and poor neonatal outcomes. This multisystem involvement can be assessed by fundoscopy, which serves as an indicator for generalized microvascular abnormalities. Our study aims to evaluate the correlation of hypertensive retinopathy with the severity of HDP and maternal and fetal outcomes. Materials and methods The study was conducted at a tertiary care hospital in Vijayapura from October 2021 to March 2022 among admitted cases of HDP. Detailed history, blood pressure (BP) measurement, obstetric examination, and fundoscopy were performed for all cases. Patients were followed up until the 10th postnatal day. The mode of delivery, birth weight, gestational age at birth, and any other neonatal outcomes were noted. Results We included 94 preeclampsia/eclampsia patients with a median age of 23 years, 51 (54.3%) being primigravida. Patients with chronic hypertension, gestational hypertension, and chronic hypertension superimposed by preeclampsia/eclampsia were excluded. The most common symptom in mothers was headache (23.4%), followed by blurring of vision (20.2%) and epigastric pain (5.3%) with a significant association (p < 0.05). Thirty-two cases (34%) had preterm deliveries with a positive association with the severity of retinopathy (p < 0.05). The magnitude of hypertensive retinopathy was 56.3% (53 cases), the severity of which significantly correlated to the severity of HDP (p < 0.05). We report 8.5% neonatal mortality and 22.3% small for gestational age (SGA) with a positive association with HDP severity (p < 0.05). There was no correlation between serum creatinine levels and the severity of retinopathy and fetal outcome. Conclusion The occurrence and severity of hypertensive retinopathy increase with increasing severity of HDP. Complaints, such as headache, blurred vision, and epigastric pain, are reported higher in cases with retinopathy. The severity of retinopathy may be used as an indicator of fetal morbidity; however, studies with large sample sizes and advanced tools are required to quantify the cause-effect relationship. The retinopathy associated with HDP resolves naturally with BP control postnatally.

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Retinal Changes in Pregnancy Induced-Hypertension

Cited by 3 publications

References 6 publications

Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study

Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study

Pregnancy Induced Hypertension and Retinopathy

Retinal Microvascular Characteristics and Outcomes in Hypertensive Disorders of Pregnancy.

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