Clinical study of fundus findings in pregnancy induced hypertension

BACKGROUND AND OBJECTIVES: To study the role of ophthalmoscopy in pregnancy induced hypertension (PIH) in diagnosis, prognosis, differential diagnosis, line of treatment and effect of treatment. MATERIALS AND METHODS: An observational study in which all the patients for the study are selected from antenatal clinic, antenatal wards and preeclampsia and eclampsia room in Department of Obstetrics and Gynecology, General Ophthalmic Out Patient Department (OPD) in case of ambulatory patients, during the period of Nov. 2003 to June 2006 randomly. In every case detail obstetric history, general examination and relevant pathological investigations were carried out. In every case, pupil was dilated with homatropine (2%) eye drops and detailed ophthalmic examination was carried out. RESULTS: In our study out of 300 cases of PIH, there are 182 cases of mild preeclampsia and 76 cases of severe preeclampsia and 42 cases of eclampsia. Among these, 37 cases (20.33%) of mild preeclampsia and 75 cases (98.68%) of severe preeclampsia and 41 cases (97.62%) of eclampsia show positive fundus changes. The incidence of pre-term babies, intra uterine death, still birth and low birth weight infants is high in mothers having positive fundus changes, i.e. for pre-term infant (72.46%), still birth (62%) and low birth weight (45.56%) in our series The perinatal mortality is higher in patients having Grade II (33.85%), Grade III (54.29%), Grade IV (100%) hypertensive retinopathy. CONCLUSION: Retinal examination reveals important objective information in PIH, furthers their accurate diagnosis and refines their management.