Thursday, February 20, 2014

Q: 28 year old female is admitted to ICU with HELPP syndrome. Delivery was planned. Patient start complaining of bilateral blurring of vision. What could be the complication?


Answer: Retinal detachment

Retinal detachment is an unusual but very well documented complication of severe preeclampsia and patients with HELLP syndrome. Emergent ophthalmic consultation should be obtained along with planned delivery.
Reference:

1. McEvoy M, Runciman J, Edmonds DK, Kerin JF. Bilateral retinal detachment in association with preeclampsia. Aust N Z J Obstet Gynaecol 1981; 21: 246–247

2. Ramaesh K, Nagendran S, Saunders DC. Choroidal ischaemia and serous retinal detachment in toxaemia of pregnancy. Eye 1999; 13: 795–796

3. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with haemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol 1993; 169: 1000–1006

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