Pol Shraddha, Upasani Shradhda D
Department of Obstetrics and Gynecology at Lokmanya, Tilak Municipal Medical College and General Hospital, Mumbai, India.
Upasani Superspeciality Hospital, Mulund West, Mumbai, India.
J Obstet Gynaecol India. 2022 Dec;72(Suppl 2):366-368. doi: 10.1007/s13224-021-01581-z. Epub 2022 Mar 7.
Glaucoma is a complex disease which when encountered in pregnancy poses a challenge to the woman's obstetrician and her ophthalmologist. The dilemma arises while opting the line of management, either medical or surgical which requires balancing the clinical disease of the mother with the potential threat of therapy to the growing child. Such was our case an elderly primigravida 10 weeks of gestation who had an acute episode of angle closure glaucoma with diminishing vision, who was managed both medically (anti-glaucoma drugs) and surgically (trabeculectomy). She recovered with a normal IOP, improved vision and anomaly scan of the fetus showing a structurally normal fetus. Thus, the fear of uncertain drug teratogenicity should not discourage doctors from prescribing treatments when their expected benefits to the mother are thought to outweigh the risk to the fetus.
青光眼是一种复杂的疾病,在孕期出现时会给孕妇的产科医生和眼科医生带来挑战。在选择治疗方案时会出现两难局面,无论是药物治疗还是手术治疗,都需要在母亲的临床疾病与治疗对发育中胎儿的潜在威胁之间取得平衡。我们遇到的一个病例就是如此,一位妊娠10周的高龄初产妇发生了急性闭角型青光眼,视力下降,我们对其进行了药物治疗(抗青光眼药物)和手术治疗(小梁切除术)。她眼压恢复正常,视力改善,胎儿的超声检查显示结构正常。因此,当认为对母亲的预期益处大于对胎儿的风险时,不应因担心药物致畸性不确定而阻碍医生开具治疗处方。