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MYOPIA AND DELIVERY. Should mode of delivery be influenced by moderate and high myopia?
Oleg Petrović
; Klinika za ginekologiju i porodništvo KBC Rijeka,Medicinski fakiltet Sveučilišta u Rijeci, 51 000 Rijeka, Cambierieva 17
Mirko Prodan
; Klinika za ginekologiju i porodništvo KBC Rijeka,Medicinski fakiltet Sveučilišta u Rijeci, 51 000 Rijeka, Cambierieva 17
Karmen Lončarek
; Klinika za oftalmologiju KBC Rijeka,Medicinski fakiltet Sveučilišta u Rijeci, 51 000 Rijeka, Cambierieva 17
Sanja Zaputović
; Klinika za ginekologiju i porodništvo KBC Rijeka,Medicinski fakiltet Sveučilišta u Rijeci, 51 000 Rijeka, Cambierieva 17
Nebojša Sindik
; Klinika za ginekologiju i porodništvo KBC Rijeka,Medicinski fakiltet Sveučilišta u Rijeci, 51 000 Rijeka, Cambierieva 17
Sažetak
Objective. Many obstetricians and ophthalmologists recommend in cases of preexisting high myopia either a cesarean section or an instrumental vaginal delivery, although these recommendations are not evidence based. According to a changed professional policy at author’s Department, moderate and high myopia were not indications for an elective operative delivery any more (since 2003). The aim of the study was to investigate did a changed obstetric policy had any implication on patient’s health, especially on vision condition, and perinatal outcome. Authors decided to give recommendations regarding optimal mode of delivery of pregnant women with moderate and high myopia. Methods. In a 5-year retrospective study a comparison between three groups of pregnant patients with low, moderate and high myopia regarding a mode of delivery of term single pregnancies and perinatal outcome is presented. Authors were interested particularly on eventual progression of retinal changes in mothers after deliveries. Results. The study encompassed 240 pregnant women. Out of total there were 137 patients with low myopia, 54 patients with moderate myopia, and 49 patients were highly myopic. The incidences of cesarean section in the studied groups of women were 11%, 14.8%, and 10.2%, respectively. There were not statistically significant differences either among the mentioned results or in relation to an average incidence of cesareans during the same study period, which was 10.1%. Not even a single elective cesarean was performed due to patient’s myopia of any degree. The incidences of instrumental vaginal deliveries with vacuum extraction were 5.1% in the group of women with low myopia, 1.9% in the group of patients with moderate myopia, and 12.2% in highly myopic group. The last result was significantly higher than the percentages of vacuum extractions in patients with low and moderate myopia, and in relation to an average incidence of vaginal deliveries with vacuum extraction during the same study period, which was 1.9%. Not a single case of either a retinal detachment or any other vision disturbance was recorded. Conclusion. With almost identical rates of cesarean section reported in the groups of eumetropic, low, moderate and high myopic puerperas, there was not even a single case of acute deterioration of patient’s visus. Authors concluded that spontaneous vaginal birth as a first option is an accurate mode of delivery for women with moderate and high myopia, and in those cases planned cesarean section is not justified.
Ključne riječi
term pregnancy; myopia; vaginal birth; instrumental delivery; cesarean section
Hrčak ID:
65707
URI
Datum izdavanja:
1.3.2009.
Posjeta: 7.152 *