A Study of Fundus Changes in Patients with Pregnancy Induced Hypertension Attending Tertiary Care Centre

Abstract

Introduction: Retinal changes are a frequent observation in pregnancy-induced hypertension. Early detection and monitoring of these changes can help to determine the further course of pregnancy. The study is intended to determine the prevalence of retinal changes in pregnancy-induced hypertension (PIH) and the association of these changes with the blood pressure, proteinuria, and disease severity. Methods: All patients admitted with the diagnosis of PIH were observed in this study. Age, gravida, gestational period, blood pressure, and proteinuria were noted. A proper history of any ophthalmological symptoms and Fundoscopic examination was done after dilation of the pupils with a direct ophthalmoscope in, the ward itself. All findings were noted and then analyzed. Results: A total of 75 patients of PIH were examined. The mean age of patients was 24.88 years (range 18-39 years). The gestation period ranged from 27 weeks to 42 weeks; 40 (53.33%) were primigravida. 35(46.66%) were multigravida. 44 (58.66%) patients had mild preeclampsia, 26 (34.66%) had severe preeclampsia and 5 (6.66%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in 25 (33.33%) patients --- grade I in 19 (25.33%) and grade II in 4 (5.33%). Haemorrhages or exudates were seen in 1 (1.33%) patient and retinal detachment was seen in 1(1.33%) patient. There was a statistically significant positive association between retinal changes and blood pressure (p<0.0001), proteinuria (p=0.0000036) and severity of the PIH (p=0.0001). Conclusion: Ophthalmic fundus examination is an important procedure to be performed in all pregnant hypertensive women. It helps to determine the further course of pregnancy. In our study, Retinal changes were seen with PIH and they were significantly associated with blood pressure, proteinuria, and severity of the disease. [D Patel, Natl J Integr Res Med, 2018; 9(1):7-11]