Prevalence and risk factors of ocular fundus changes among pregnant women with pregnancy induced hypertension at a tertiary care center

Abstract

Background: Pregnancy-induced hypertension (PIH) can affect the eyes of pregnant women. There is dysfunction of vascular endothelium among them. There can be further leakage from capillaries and vasospasm if it is left untreated. Objective: The objective of this study was to study the prevalence and risk factors of ocular fundus changes among pregnant women with PIH. Materials and Methods: A hospital-based, cross-sectional study was carried out among 130 pregnant women with PIH. History of symptoms related to the eyes, age, and gravida was recorded. Torchlight was used to examine the anterior segment. One percentage of tropicamide was used to dilate pupils. Direct ophthalmoscope was used to examine the fundus. Blood pressure was measured as per the standard guidelines. Urine sample was taken to look for the presence of proteins in urine. Results: The majority belonged to 23–27 years (50%) and the majority (54.6%) had gestational age >37 weeks. The majority (75.38%) had gestational hypertension. The prevalence of retinopathy was 11.5%. Grade I retinopathy was the most common (7.7%). Age was not associated with retinopathy. The prevalence of PIH among women with preeclampsia was 29.1% compared to 5.1% in women with gestational hypertension and it was significant (P < 0.05). The prevalence of PIH among women with blood pressure >150/100 mmHg was 43.3% compared to 2% in women with blood pressure <150/100 mmHg, and it was significant (P < 0.05). The prevalence of PIH among women with severe proteinuria (+++) was 60% compared to 42.9% in moderate proteinuria (++), 20% in mild proteinuria (+), and only 5.4% in women without proteinuria. These differences were significant (P < 0.05). Conclusion: The prevalence of retinopathy among pregnant women with PIH was high. High blood pressure and severe proteinuria and preeclampsia were significantly associated with retinopathy.