The effect of normal childbirth on eyes with abnormalities predisposing to rhegmatogenous retinal detachment.
BACKGROUND
Pregnant women who have high myopia, a history of retinal detachment or retinal holes, or have known lattice degeneration are frequently referred to an ophthalmologist for advice concerning the management of pregnancy and labor, i.e. whether a spontaneous vaginal delivery can be allowed and whether prophylaxis for high-risk retinal pathology is indicated. Many obstetricians still believe that pregnant women with ocular abnormalities predisposing to rhegmatogenous retinal detachment should have an instrumental delivery, and a few even advocate cesarian section. Very little has been written about the management of pregnant women with high-risk retinal pathology, and opinions differ considerably. Patient data on this subject are scarce.


METHODS
We studied 10 women who had 19 deliveries (10 prospective and 9 retrospective) and who had a history of retinal detachment, had been diagnosed as having extensive lattice degeneration, or had been treated for symptomatic retinal holes or breaks. The women were followed from the third trimester of pregnancy through labor and delivery into the postpartum period, looking for changes in the retinal status.


RESULTS
We found no changes in the retinal status in the postpartum examination.


CONCLUSIONS
We conclude that prenatal treatment of asymptomatic retinal pathology is not indicated and that spontaneous vaginal delivery may be allowed to take place in women with high-risk retinal pathology.
Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel.
D
D
Landau
M H
MH
Seelenfreund
O
O
Tadmor
B Z
BZ
Silverstone
Y
Y
Diamant
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology*; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012162:Retinal Degeneration / Q000209:etiology / Q000473:pathology; D012163:Retinal Detachment / Q000209:etiology / Q000503:physiopathology*; D012167:Retinal Perforations / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies