Publication:

A study of prevalence and association of fundus changes in pregnancy induced hypertension

Background The pathological changes of pregnancy induced hypertension appear to be related to vascular endothelial dysfunction and its consequences. The retinal vascular changes generally, but not always, correlate with the severity of systemic hypertension. To find out the prevalence and association of retinal changes in pregnancy induced hypertension.

Methods A hospital based cross-sectional study was conducted where all antenatal pregnant women who fulfilled the diagnostic criteria of PIH were included in this study. Patients who had pre-existing diabetes or hypertension or renal disease or hazy media which did not permit fundus visualization were excluded from the study.Socio-demogrpahic and obstetric data was collected and all the patients were subjected to detailed clinical examination followed by fundoscopic examination.

Results Out of the total 423 patients of PIH examined, the retinal changes (hypertensive retinopathy changes) were noted in 181 (42.7%) patients. The prevalence of retinopathy changes was more among patients with imminent Eclampsia (76.5%) and eclampsia patients (50%). As the severity of the PIH increased the Odds of women developing retinopathy also increased substantially from OR: 17.6; 95% CI: 3.1-136.3 in severe PIH to OR: 253; 95% CI: 47.2-1935 in Imminent eclampsia and this association between the severity of PIH and the development of retinopathy changes was found to be statistically significant.

Conclusions Fundus examination in cases of PIH is of paramount importance in monitoring and managing cases as it co-relates with the severity of PIH.