Ophthalmological Disorders and Laboratory and Clinical Indicators in Women with Hypertensive Pregnancy Complications
https://doi.org/10.52420/umj.23.3.59
EDN: UFIQND
Abstract
Introduction. Hypertensive disorders during pregnancy, despite many epidemiological studies, scientific developments, and the improvement of laboratory and instrumental techniques for searching for predictors of preeclampsia, are a serious problem of perinatal obstetrics. One of these areas may be an in-depth ophthalmological examination.
The aim of the work is to perform an analysis of ophthalmological disorders and laboratory, clinical parameters in women with hypertensive complications of pregnancy.
Materials and methods. A retrospective analysis of 573 cases of hypertensive pregnancy complications was performed. The age of the patients ranged from 15 to 50 years. All patients received a standard general clinical and obstetric examination, examined by an ophthalmologist. A correlation analysis of some laboratory and clinical signs of arterial hypertension (AH) and preeclampsia (PE), including ophthalmological signs of PE, was carried out. Results: PE was accompanied by retinal angiopathy in 67 % of cases. In 9 cases (1.86 %), peripapillary edema was detected in PE. In the presence of peripapillary edema, earlier delivery dates and a lower Apgar score were observed in the newborn. Macular edema was registered in 3 cases (0.62 %) against the background of gestational diabetes mellitus.
Conclusion. Comparative analysis has shown the presence of correlations between signs of hypertensive complications of pregnancy and changes in the organ of vision. The expansion of ophthalmological research may provide new markers-indicators for the differential diagnosis of hypertensive complications of pregnancy, assessment of the severity of the condition, dynamic monitoring and choice of management tactics for patients with hypertensive complications of pregnancy.
About the Authors
S. V. BarinovRussian Federation
Sergey V. Barinov — Doctor of Sciences (Medicine), Professor, Head of the Department of Obstetrics and Gynecology No. 2
Omsk
T. Yu. Matnenko
Russian Federation
Tatyana Yu. Matnenko — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Ophthalmology
Omsk
Yu. I. Chulovsky
Russian Federation
Yuri I. Chulovsky — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Yu. A. Kovaleva
Russian Federation
Yulia A. Kovaleva — Head of the Obstetric Department of Pregnancy Pathology of the Perinatal Center
Omsk
M. A. Voronkova
Russian Federation
Maria A. Voronkova — Ophthalmologist of the Department of Pathology of Newborns and Premature Infants of the Perinatal Center
Omsk
References
1. Balushkina AA, Tyutyunnik VL, Kan NE, Kharchenko DK, Boris DA. Prognosis and laboratory diagnostics of hypertensive disorders during pregnancy. Russian Journal of Woman and Child Health. 2019;2(2):89–94. (In Russ.). EDN: https://elibrary.ru/ivtrvm.
2. Rudakova IS, Shifman EM, Tikhova GP, Pylaeva NYu. Hypertensive disorders during pregnancy as a risk factor for premature placental abruption. Meta-analysis. Russian Journal of Anesthesiology and Reanimatology. 2023;(2):6–14. (In Russ.). DOI: https://doi.org/10.17116/anaesthesiology20230216.
3. Nagy ZZ. Review of the ophthalmic symptoms of preeclampsia. Developments in Health Sciences. 2020;3(1):21–23. DOI: https://doi.org/10.1556/2066.2020.00005.
4. Xinyi He, Yimei Ji, Meiting Yu, Yuhua T. Chorioretinal alterations induced by preeclampsia. Journal of Ophthalmology. 2021;2021:8847001. DOI: https://doi.org/10.1155/2021/8847001.
5. Muminova KT, Hodzhaeva ZS, Shmakov RG. Specifics of pregnancy in patients with hypertensive disorders. Doctor.Ru. 2019;11(166):14–21. (In Russ.). DOI: https://doi.org/10.31550/1727-2378-2019-166-11-14-21.
6. Ankudinov NO, Martirosyan SV, Salimova IV, Sitnikov AF, Sitnikov FA. Hypertensive disorders during pregnancy. Technologies of remote monitoring of patients’ health. Clinical Analysis in Obstetrics, Gynecology and Reproductology. 2022;(1–2):11–16. (In Russ.). EDN: https://elibrary.ru/cadezu.
7. Belotserkovtseva LD, Ivannikov SE, Borisova TD. The influence of the mother’s age on the course and outcomes of pregnancy at the first birth (single-center study). Russian Bulletin of Obstetrician-Gynecologist. 2021;21(4):48–53. (In Russ.). DOI: https://doi.org/10.17116/rosakush20212104148.
8. Ivanov II, Lyashenko EN, Rumyantseva ZS, Asanova LD, Kumelsky ED. Clinical features of pregnancy, the childbirth, the post-natal period and the state of newborn in different age groups of women. Tauride Medico-Biological Bulletin. 2017;20(2–2):41–45. (In Russ.). EDN: https://elibrary.ru/zfiycp.
9. Chulkov VS, Martynov AI, Kokorin VA. Arterial hypertension in pregnant women: Debatable issues of national and international recommendations. Russian Journal of Cardiology. 2020;25(S4):46–54. (In Russ.). DOI: https://doi.org/10.15829/1560-4071-2020-4181.
10. Shelukhin AP, Baev OR, Krasny AM. Comparison of the course and outcomes of pregnancies complicated by hypertensive disorders. Obstetrics and Gynecology. 2023;1:41–47. (In Russ.). DOI: https://doi.org/10.18565/aig.2022.248.
11. Chulkov VS, Syundyukova EG, Chulkov VS, Tarasova OA, Romanyugo GD. Hypertensive disorders during pregnancy and the risk of cardiovascular diseases. Russian Journal of Preventive Medicine. 2021;24(12):97–104. (In Russ.). DOI: https://doi.org/10.17116/profmed20212412197.
12. Chappell LC, Tucker KL, Galal U, Yu LM, Campbell H, Rivero-Arias O, et al. Effect of self-monitoring of blood pressure on blood pressure control in pregnant individuals with chronic or gestational hypertension: The BUMP 2 randomized clinical trial. JAMA. 2022;327(17):1666–1678. DOI: https://doi.org/10.1001/jama.2022.4726.
13. Ye L, Shi MD, Zhang YP, Zhang JS, Zhu CR, Zhou R. Risk factors and pregnancy outcomes associated with retinopathy in patients presenting with severe preeclampsia: A retrospective cohort study. Medicine. 2020;99(11):e19349. DOI: https://doi.org/10.1097/MD.0000000000019349.
14. Lee CS, Choi EY, Lee M, Kim H, Chung H. Serous retinal detachment in preeclampsia and malignant hypertension. Eye. 2019;33(11):1707–1714. DOI: https://doi.org/10.1038/s41433-019-0461-8.
15. Soma-Pillay P, Pillay R, Wong TY, Makin JD, Pattinson RC. The effect of pre-eclampsia on retinal microvascular caliber at delivery and post-partum. Obstetric Medicine. 2018;11(3):116–120. DOI: https://doi.org/10.1177/1753495X17745727.
16. Brussé IA, van den Berg CB, Duvekot JJ, Cipolla MJ, Steegers EAP, Visser GH. Visual evoked potentials in women with and without preeclampsia during pregnancy and postpartum. Journal of Hypertension. 2018;36(2):319–325. DOI: https://doi.org/10.1097/HJH.0000000000001521.
17. Poon LC, Magee LA, Verlohren S, Shennan A, von Dadelszen P, Sheiner E, et al. A literature review and the best practice advice for second and third trimester risk stratification, monitoring, and management of pre-eclampsia. International Journal of Gynecology & Obstetrics. 2021;154(S1):3–31. DOI: https://doi.org/10.1002/ijgo.13763.
18. Sibony PA, Kupersmith MJ, Kardon RH. Optical coherence tomography neuro-toolbox for the diagnosis and management of papilledema, optic disc edema, and pseudopapilledema. Journal of Neuro-Ophthalmology. 2021;41(1):77–92. DOI: https://doi.org/10.1097/WNO.0000000000001078.
19. Yang JY, Wang Q, Yan YN, Zhou WJ, Wang YX, Wu SL, et al. Microvascular retinal changes in pre-clinical diabetic retinopathy as detected by optical coherence tomographic angiography. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2020;258(3):513–520. DOI: https://doi.org/10.1007/s00417-019-04590-x.
20. Phasukkijwatana N, Freund KB, Dolz-Marco R, Al-Sheikh M, Keane PA, Egan CA, et al. Peripapillary pachychoroid syndrome. Retina. 2018;38(9):1652–1667. DOI: https://doi.org/10.1097/IAE.0000000000001907.
21. Kabardina EV, Shurygina IP. Modern ideas about retinal vein thrombosis. Kuban Scientific Medical Bulletin. 2019;26(1):187–195. (In Russ.). DOI: https://doi.org/10.25207/1608-6228-2019-26-1-187-195.
22. Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: Long-term consequences for mother and child. American Journal of Physiology-Renal Physiology. 2020;318(6):F1315–F1326. DOI: https://doi.org/10.1152/ajprenal.00071.2020.
23. Tok A, Beyoğlu A. Antenatal and postpartum comparison of HD-OCT findings of macula, retinal nerve fiber layer, ganglion cell density between severe preeclampsia patients and healthy pregnant woman. Hypertension in Pregnancy. 2020;39(3):252–259. DOI: https://doi.org/10.1080/10641955.2020.1758938.
24. Ciloglu E, Okcu NT, Dogan NÇ. Optical coherence tomography angiography findings in preeclampsia. Eye. 2019;33(12):1946–1951. DOI: https://doi.org/10.1038/s41433-019-0531-y.
25. Monteiro-Henriques I, Rocha-Sousa A, Barbosa-Breda J. Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A review. Acta Ophthalmologica. 2022;100(1): e1–e15. DOI: https://doi.org/10.1111/aos.14851.
Review
For citations:
Barinov SV, Matnenko TY, Chulovsky YI, Kovaleva YA, Voronkova MA. Ophthalmological Disorders and Laboratory and Clinical Indicators in Women with Hypertensive Pregnancy Complications. Ural Medical Journal. 2024;23(3):59-70. (In Russ.) https://doi.org/10.52420/umj.23.3.59. EDN: UFIQND