Publication:

Comparative study of fundus changes in hypertensive and normotensive pregnant females in third trimester at tertiary care centre

Background According to ACOG, hypertension in pregnancy can be defined as systolic blood pressure of 140mmhg or higher, diastolic blood pressure of 90mmhg or higher confirmed on atleast two occasions 4-6 hours apart but within a maximum of a week period. The retinal vascular changes have been said to correlate with the severity of hypertension. Many studies have considered the progression of retinal vascular changes as a sign of increasing severity of PIH and have correlated them with fetal mortality. The aim of the study was to comparison of fundus changes among hypertensive and normotensive pregnant female in third trimester.

Methods 50 hypertensive and 50 normotensive pregnant women were included in the study. All patients fulfilling inclusion and exclusion criteria diagnosed with pre-eclampsia, eclampsia, chronic hypertension were studied for ocular fundus changes and retinal changes were graded according to Keith Wagener classification.

Results Nearly 3/4th of patients in this study group were primigravida. 64% of patients were in the gestational age less than 36weeks. A significant number of PIH changes were noted in the age group 21-25 however significant number of fundal changes were noted in age group 26-30. 58.33% of study group showed fundal changes of grade III.

Conclusions The vascular changes in the retina correlate with the severity of the systemic and vascular involvement. Fundoscopy should be offered to all hypertensive pregnant females so that if positive findings are noted, active intervention can be done correlating with other radiological and biochemical findings.