A One Year Cross Sectional Study of Fundal Changes in Patients with Pregnancy Induced Hypertension Attending KLES’ Prabhakar Kore Hospital and Medical Research Centre, Belgaum

Abstract

INTRODUCTION: ABSTRACT Pregnancy Induced Hypertension ( PIH ) is a systemic disease which usually occurs after 20 th week of pregnancy in approximately 5% of pregnant females. Ocular involvement in patients with PIH may range from arteriolar narrowing to blindness due to retinal detachment and visual cortex ischemia. This one year study evaluated frequency and spectrum of retinal fundus changes in patients with PIH and relationship between degree of hypertensive retinopathy to severity of PIH. METHODOLOGY: 130 patients with PIH were included in study after applying inclusion and exclusion criteria. Detailed ocular history and examination was done in each patient including fundoscopy. Investigations like urine protein, blood urea, serum uric acid, platelet count was done is all the patients to know the systemic severity of the disease. Data was collected in predetermined proforma and results were analysed. OBSERVATIONS AND RESULTS: 130 patients with age range from 18 to 40 years were included in study. 56.15% of these were primigravidas while 79.23% were in more than 32 weeks of gestation. 77 patients had mild preeclampsia, 43 had severe preeclampsia and 10 patients had eclamptic convulsions. 57.69% of patients had grade I retinopathy, 3 patients each had grade II and III retinopathy. 2 patients had papilledema where as total of 4 patients developed exudative retinal detachment as a complication of PIH. 42 patients had normal fundus picture. Analysis of data showed that the risk of IX developing hypertensive retinopathy increases with increasing severity of PIH from mild preeclampsia through severe preeclampsia to eclampsia. CONCLUSION: This study shows that even with increasing health awareness and improving standard of treatment; rare ocular complications of PIH like retinal detachment do occur along with less severe changes of retinal vasculature. Also, this study shows that with increasing severity of PIH there is a greater chance of developing of retinopathy.