RETINAL AND PREGNANCY OUTCOMES IN THE PRESENCE OF DIABETIC PROLIFERATIVE RETINOPATHY

The objective of this study was to examine the retinal and pregnancy o utcomes of pregnancies complicated by advanced diabetic retinopathy. T wenty pregnancies complicated by advanced diabetic retinopathy were in cluded in this retrospective study. The data were analyzed to determin e trends in perinatal outcome and to document the ophthalmologic perfo rmance. Ophthalmologic management included frequent funduscopic examin ations by ophthalmologists of the Yale Retina Center. Among the 20 pre gnancies, spontaneous abortion occurred in 2 (10%) and stillbirth in 1 (5%); the remaining 17(85%) pregnancies culminated in live births at a mean gestational age of 36 weeks (+/-2.3 SD), with a mean birth weig ht of 2,620 g (+/- 834 SD). The perinatal survival rate was 94%. Photo coagulation therapy was necessary prior to pregnancy in 45%, during pr egnancy in 60% and postpartum in 65%. No pregnancies were terminated b ecause of progressive visual changes that did not respond to photocoag ulation therapy. Retinal status should not preclude pregnancy since co ntemporary methods of management can result in satisfactory retinal an d pregnancy outcomes evert in the presence of advanced diabetic microv ascular disease.