Two cases of serous retinal detachment with placental abrupt
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Visual disorders occur in 25 to 50% of patients with severe preeclampsia (PE). Representative ophthalmic disorders associated with PE include cortical blindness and posterior reversible encephalopathy syndrome (PRES), with retinal detachment occurring less frequently. Retinal detachment accompanying placental abruption is rare and, to date, only a few case reports have been published. Here, we report two cases of serous retinal detachment that occurred in life-threatening placental abruption with PE. Multiple diagnostic modalities, including magnetic resonance imaging, scanning laser ophthalmoscopy, and optical coherence tomography, were useful in these cases.

A 28-year-old primigravida was transferred to our hospital at 38 weeks and 1 day of gestation with severe lower abdominal pain. She had no history of hypertension or ophthalmic disease. At a previous clinic visit at 36 weeks and 0 days of gestation, her blood pressure was elevated at 144/77 mmHg and there was positive urinary protein by dipstick and poor fetal growth on ultrasonography. At 38 weeks and 1 day of gestation, she visited the clinic due to sustained severe abdominal pain and uterine tenderness. Her blood pressure was 190/110 mmHg and ultrasonography revealed no fetal heartbeat. During the transfer to our hospital, she experienced diplopia. On arrival, she was alert though her face was pale, and uterine tenderness and edema of both legs were prominent. Her blood pressure was 159/107 mmHg and dipstick urine protein was 3+. On ultrasonography, extensive retroplacental hematoma was observed. Under the diagnosis of placental abruption with intrauterine fetal death and PE, labor induction by oxytocin was initiated, and a 2,290 g stillborn infant was vaginally delivered. Blood transfusion was required because the total amount of bleeding was 3,480 g. Blood pressure was maintained between 120–130 and 60–70 mmHg by nicardipine infusion during labor....
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