Myopia – real or mythical reason for performing C-section?

R. Barac, M. Pop, F. Baltă, C. Taban, S. Vlădăreanu, C. Mehedințu

Rezumat: Many obstetricians still believe that pregnant women with ocular abnormalities such as myopia, retinal detachment, glaucoma or diabetic retinopathy should have an instrumental delivery, and a few even advocate cesarian section. There is no evidence based study regarding the best management of pregnant women with high-risk retinal pathology available so far. We studied 2 women with high myopia who had 4 deliveries (one prospective and 3 retrospective deliveries) and who had a history of surgically resolved retinal detachment, had been diagnosed as having extensive lattice degeneration (abnormal areas with thin retinal layers in the periferal field, predisposed to retinal breaks), or had been treated for symptomatic retinal holes or breaks. The women were followed from the third trimester of pregnancy throughout all stages of labor and delivery and in the postpartum period, looking for changes in the retinal status. We found no retinal changes between examinations performed pre-, intra- and post-partum examination. Spontaneus vaginal delivery was safely performed in the four pregnancies we followed. Our study showed no benefit from prenatal treatment of asymptomatic retinal pathology and that spontaneous vaginal delivery may be allowed in women with high-risk retinal pathology, thus confirming findings published by previous studies.
Cuvinte cheie: myopia, retinal detachment, vaginal delivery.