Preeclampsia/Eclampsia and Retinal Micro Vascular Characteristics Affecting Maternal and Foetal Outcome: A Prospective Study amongst South Indian Pregnant Women

The association of hypertension with pregnancy is still an unsolved puzzle. This problem confronted by the obstetrician is quite challenging, considering the high incidence of maternal and foetal complications associated with preeclampsia/ Eclampsia syndrome.  It is extremely difficult to identify the clinical features or any parameter which would alarm the high risk to the mother or the foetus. Vasospasm is basic to the patho-physiology of preeclampsia. Clinical evidence of vasospasm may be obtained by ophthalmologic examination. The various pathological changes in different organs of body can be studied by directly studying the ocular fundus and may give a true index of changes in vascular system of brain and kidneys. The aim of the study: To analyse the presence of retinal changes in preeclampsia and its relevance to maternal and foetal outcome. Study design –Prospective   study, conducted at the Government Lady Goschen Hospital, Mangalore, Karnataka India, during the years from June 1997 to June 1999, as a Postgraduate Dissertation work with recent updates. Method: 100 consecutive patients with preeclampsia were included in the study. Necessary laboratory investigations from samples of blood and urine were performed. Special investigations like Ultrasonography and fundoscopy were conducted. Maternal and perinatal complications were studied in patients with preeclampsia with retinal changes. Results: 60% of patients with preeclampsia showed fundal changes. Those who had retinal changes suffered complications like abruptio-placentae, Eclampsia, preterm delivery, low birth weight and perinatal deaths. Conclusions: Significant proportion of women with preeclampsia had retinal changes. These women are found to be at a greater risk for adverse pregnancy outcome. Prompt termination of pregnancy would prevent maternal complications; improve foetal outcome thereby reducing perinatal mortality.