Diabetic retinopathy (DR) may progress when diabetic women pregnant. It is clear that DR cases are increasing around the world and the danger is alarming. This is a retrospective case with 168 pregnant patients which were traced from the registry held by Endocrine Antenatal Clinic, Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre from 2016 to 2019. Of the 138 pregnancies in pre-existing diabetics, 97 records (70.3%) were found to have only one follow-up with incomplete ophthalmology records or defaulters. Only 41 pregnancy records (29.7%) completed with at least two ophthalmology reviews during the pregnancy. Progression of DR was noted in seven of these pregnancies, giving a rate of 17.0%. One eye of one patient progressed from mild non-proliferative DR to sight-threatening proliferative DR (PDR). When comparing the group of progressors with non-progressors, there was no statistically significant difference for risk factors (age, gender, ethnicity, type of diabetes, duration of diabetes, HbA1c level, hypertension, presence of maculopathy, risk factors for diabetes and fetal ultrasound findings). The rate of repeated follow-up for retinopathy during pregnancy in diabetics is about 30%. This study suggested that no risk factors were identified for DR progression.
Retrospective Review of Management of Diabetic Retinopathy in Pregnant Diabetics at Hospital Universiti Kebangsaan Malaysia
Abstrak
Retinopati diabetes (DR) boleh berkembang ketika wanita diabetes hamil. Situasi ini adalah jelas bahawa kes diabetes semakin meningkat di seluruh dunia dan bahayanya adalah menakutkan. Kes retrospektif dengan 168 kehamilan dikesan dari senarai pendaftaran Klinik Antenatal Endokrin, Jabatan Obstetrik dan Ginekologi, Pusat Perubatan Universiti Kebangsaan Malaysia dari jangka masa 2016 hingga 2019. Daripada 138 pesakit diabetes yang hamil, 97 rekod (70.3%) didapati hanya mempunyai satu tindakan susulan dengan rekod oftalmologi yang tidak lengkap atau ingkar. Hanya 41 rekod pesakit diabetes yang hamil (29.7%) mempunyai dua tinjauan oftalmologi. Perkembangan DR dicatat dalam 7 pesakit diabetes yang hamil dengan memberikan kadar 17.0%. Satu mata dari seorang pesakit berkembang dari DR non-proliferatif ringan menjadi DR proliferatif (PDR) yang mengancam penglihatan. Semasa membandingkan kumpulan progresor dengan bukan progresor, tidak ada perbezaan yang signifikan secara statistik untuk faktor risiko (umur, jantina, etnik, jenis diabetes, tempoh diabetes, tahap HbA1c, hipertensi, kehadiran makulopati, faktor risiko diabetes dan janin penemuan ultrasound). Kadar tindak balas berulang untuk retinopati semasa kehamilan pada pesakit diabetes adalah sekitar 30%. Kajian ini menunjukkan tidak ada faktor risiko untuk perkembangan DR.
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