Retinopatia hipertensiva e prognóstico fetal nas doenças hipertensivas da gestação

Retinopatia hipertensiva e prognóstico fetal nas doenças hipertensivas da gestação


Ayrton R. B. Ramos,
Humberto Schwartz Filho,
Carlos A. Moreira Jr.


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.58 no.4 São Paulo ago. 1995



Toxemia of pregnancy is characterized by hypertension, proteinuria, and generalized body edema, which develops during the third trimester of pregnancy. This systemic disease, which can affect almost every organ system in the body, has potentially devastating consequences for both mother and baby. The purpose of this trial is to verify the importance of fundoscopy in the diagnosis of toxemia of pregnancy as well as correlate this findings with hypertensive retinopathy and fetal outcome.

Materiais and Methods:

We performed a prospective study where pregnant women with high blood pressure, were submitted to fundoscopy and classified according Gans and Keith- Wagener-Barker (KW) classifications. After delivery, the babies were assessed according gestational age (Parkin), weight and Apgar index.


We examined 148 pregnant women between 14 and 48 years old (mean = 28,67). From these, 26 (17,6%) had mild preeclampsia, 35 (23,6%) had severe preeclampsia, 9 (6,1 %) had eclampsia and 78 (52,7%) had chronic hypertension. According KW classification, 89 (60,1%) had grade 1 retinopathy, 26 (17,6%) had grade 2 retinopathy, 24 (16,2%) had grade 3 and 4 retinopathy and 9 (6,1%) had no signs of hypertensive retinopathy. Of the 143 babies, 55 (38,5%) were low birth weight infants, 90 (62,9%) were premature, 27 (18,2%) were dead infants, 45 (31,5%) had Apgar 1,2 or 3 in the first minute and 32 (22, 4%) had Apgar 1, 2 or 3 in the fifth minute of life.


We concluded that with the fundus examination we could confirm the diagnosis of toxemia of pregnancy (p <0, 001), nevertheless it was impossible with this exam to foresee the fetal prognosis. We also concluded that the best exams to foresee the fetal outcome is the evaluation of blood pressure and the obstetrician 's diagnosis based on exams of labotatory. (p < 0,001);

Key Words: Toxemia of pregnancy; Hypertensive retinopathy; Fetal prognosis


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