No increased risk for recurrent retinal detachment in pregnant women after vaginal delivery
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Key takeaways:
- The retinal re-detachment rate was 5% after vaginal delivery and 7.5% after cesarean section.
- Researchers found no ophthalmic benefit in a cesarean section for pregnant women with a history of retinal detachment.
Pregnant women with a history of retinal detachment were at no greater risk for recurrence after vaginal delivery compared with cesarean section, according to a study published in Retina.
“In this study, we aimed to evaluate the risk of recurrent retinal detachment in women following childbirth, specifically focusing on the mode of delivery,” Asaf Shemer, MD, from the department of ophthalmology at Shamir Medical Center in Israel, and colleagues wrote. “Our findings indicate that pregnant women with a history of retinal detachment who underwent vaginal delivery did not face a greater risk of experiencing a detachment compared to those who underwent a C-section.”
Researchers conducted a retrospective analysis of 32 women younger than 45 years with previous retinal detachment, and divided them into vaginal delivery and cesarean section groups (mean age at the time of retinal detachment = 22.64 years and 21.75 years, respectively).
Of 66 deliveries included in the analysis, researchers reported a 5% rate of retinal re-detachment following vaginal delivery (n = 40) and a 7.5% rate following cesarean section (n = 26), which represented two occurrences in each group (P = .654).
For the two patients in the vaginal delivery group, the time between delivery and diagnosis of re-detachment was 17 days and 26 days, compared with 5 days and 30 days for the two patients in the cesarean section group.
“These results hold significant importance, as the recommendation for an elective C-sections for women with pre-existing eye conditions like retinal detachment is common among gynecologists,” Shemer and colleagues wrote.
Perspective
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During pregnancy, the list of concerns and possible complications for both the woman and her baby can be lengthy. For pregnant women who have a history of retinal detachment, there may be anxiety regarding whether Valsalva movements occurring during vaginal birth may put them at higher risk for re-detachment of the retina. While there is no evidence to support this concern, there are still reports of OB/GYNs recommending cesarean delivery to these women and others with existing eye disease and/or risk factors for retinal detachment.
This retrospective, observational cohort study found that women who have a history of retinal detachment were not at increased risk for retinal detachment with vaginal delivery compared with cesarean delivery.
The choice between a vaginal birth or cesarean section is a personal decision. We can reassure any patients with these concerns that there is no current evidence that should influence them to choose a specific birth plan due to a history of retinal detachment in the mother. She can make the best decision possible for herself and the health and safety of her baby without this added stressor.
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