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Retinal detachment in association with pre‐eclampsia, eclampsia, and HELLP syndrome
Author(s) -
VigilDe Gracia Paulino,
OrtegaPaz Luis
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.04.003
Subject(s) - hellp syndrome , eclampsia , medicine , retinal detachment , obstetrics , hemolysis , pregnancy , ophthalmology , retinal , genetics , biology
Objective To review case reports of retinal detachment in women with pre‐eclampsia/eclampsia. Methods Medline was searched for case reports of retinal detachment associated with pre‐eclampsia/eclampsia. Articles written in English, Spanish, or Portuguese and published between 1990 and 2010 were reviewed. Results A total of 28 cases of retinal detachment were identified; 15 were associated with severe pre‐eclampsia (3 of these probably had hemolysis, elevated liver enzymes, and low platelets [HELLP] syndrome), 9 with HELLP syndrome, 2 with eclampsia, and 2 with both HELLP syndrome and eclampsia. The majority (60%) of women were nulliparous, 4 had abruptio placentae, and cesarean delivery was performed in 76%. Retinal detachment was bilateral in 89% and associated with delivery of the fetus in 96%; 69% were diagnosed postpartum. Within 2–12 weeks postpartum, all patients had complete recovery of vision with clinical management. Conclusion Retinal detachment in pre‐eclampsia/eclampsia might be associated with HELLP syndrome, indicating that microangiophatic hemolysis might have a role in the pathophysiology of retinal detachment. Its occurrence might not be correlated with the severity of pre‐eclampsia because pre‐eclampsia is a constellation of signs and symptoms (persistent vasospasms with hemolysis and hypoalbuminemia) rather than simply being hypertension.