Natural childbirth or caesarean section - which is preferable for moderate myopia? Cases in which myopia can affect the course of pregnancy in a woman. Indications for hospitalization

12.10.2019

Myopia during pregnancy certainly deserves attention, since this disease can be complicated by pathological changes in the visual system, up to complete blindness. Pregnancy is a difficult time for any woman.

Each organ and system of the future mother's body undergoes changes, the state of health of a pregnant woman is the main factor and indicator of how the pregnancy will proceed. It is for this reason that gynecologists already at the first consultation try to find out all the details about the state of a woman's health, especially about the diseases she has suffered.

Myopia, or myopia, is a fairly common disease that occurs when there is a violation of refraction (refraction of a light beam) of the retina. With this violation, the focusing of rays from an object that a person sees does not occur on the retina, but in front of it, as a result of which visual acuity decreases.

Myopia increases the size of the eyeball, for this reason the retina is greatly stretched and thinned, as a result, it can break and detach - the most severe complication of myopia, in which vision rapidly deteriorates and complete blindness can occur.

Myopia and pregnancy - this combination is very dangerous; there is a risk of rapid retinal detachment, as the expectant mother experiences sudden pressure drops.

Causes of pathology

Myopia usually appears in adolescents between the ages of 8 and 12, by the age of 35 the progression of the disease stops. The reasons for its occurrence are not fully understood. The most common cause of myopia in humans is a hereditary factor. If one of the parents had this disease, then the child has a 50-70% chance of having the same pathology.

Sometimes myopia can be acquired as a result of the impact on the organs of vision of constant stress during frequent, especially chronic, diseases, as well as traumatic brain injuries. A normal pregnancy practically does not affect the refraction of the eye and does not cause the development of complications. But sometimes a pathological condition during pregnancy creates an additional risk of developing myopia, since:

The development of pregnancy, especially in the third trimester, is accompanied by an increase in the elasticity of the tissues of the whole body, which can complicate changes in the retina.
The pathological condition of a woman, called "toxicosis", aggravates myopia, vision falls by one or two diopters.
During childbirth, a woman experiences quite heavy physical exertion, especially during attempts, which leads to retinal hemorrhage and its detachment, and then complete blindness of the eye.

Disease classification

Ophthalmologists define several types of myopia; according to examinations and the presence of a disease in a pregnant woman at a certain stage, as well as factors that worsen the prognosis of the disease, a decision is made on the method of resolving childbirth:

Myopia of the 1st degree during pregnancy practically does not affect the possibility of natural childbirth. It is expressed by the focusing distance to the retina from 1 to 3 diopters. Mild myopia during pregnancy is not complicated by retinal defects and does not affect the course of pregnancy, and also does not create restrictions on childbirth.
Myopia of the 2nd degree during pregnancy also does not create restrictions on childbirth. However, moderate myopia (from 3 to 6 diopters) requires close attention from an ophthalmologist, since there is a risk of developing retinal pathologies.
High, - from 6 diopters and above, may be accompanied by retinal dystrophy. In this case, in order to reduce the risk of developing retinal detachment and subsequent blindness, doctors decide on a caesarean section as the only possible way to resolve the pregnancy. In cases where the vision of a pregnant woman is quite low, but, according to the survey, there is no retinal dystrophy, a woman can give birth naturally, but during childbirth, a perineotomy is performed - an incision in the perineum, with the help of which attempts are shortened and the load on the woman's body is reduced. Sometimes, with signs of a sharp development of retinal dystrophy and the threat of its detachment during pregnancy, doctors at the council raise the question of terminating the pregnancy, since further bearing of the child and subsequent childbirth can lead the woman to complete blindness.

Symptomatic manifestations

The most striking symptom of the development of myopia can be blurred vision when trying to see something located at a distance. In some cases, a woman does not notice changes until she becomes pregnant, then when the first ones appear, she should immediately consult a specialist doctor, especially if there were no vision problems before pregnancy. Signs of myopia are easy enough to notice:

discomfort in the eyes, rapid eye fatigue;
headaches in the forehead, discomfort in the eye sockets;
clouding and distortion of objects of observation;
flickering before the eyes, the appearance of bright "flashes".

If at least some of these signs are found, a woman should immediately undergo an examination by an ophthalmologist, take preventive measures, which consist in changing her character and habits: it is necessary to alternate visual loads with rest periods, and do special visual gymnastics. The workplace associated with visual activity should be well lit and comfortable.

Treatment of myopia in pregnant women

More suitable preventive measures for every woman expecting a baby can be advised by an ophthalmologist. He can also prescribe a special individual treatment, the method of which is selected based on the diagnosis of the patient. Diagnosis of the disease and the degree of its development is determined by the doctor on the basis of an examination of the fundus with the help of special equipment.

The easiest way to correct vision is to wear glasses or special lenses. However, it should be noted that this method does not stop the development of the disease, but only improves the ability to see normally.

Sometimes, even with the constant wearing of glasses, vision continues to deteriorate. For the treatment of myopia, an effective method based on laser correction is used, which reduces the refractive power of the eyes, as a result of which 100% vision returns. But the method of laser correction is contraindicated for pregnant women.

There is another way to deal with myopia, quite painless and carried out even in pregnant women, provided there is no preeclampsia - a sharp increase in blood pressure.

The method of laser coagulation is based on strengthening the retina, preventing its further degeneration and detachment.

This method is mainly used when an ophthalmologist diagnoses progressive myopia and the risk of complications.

To prevent myopia, you should do gymnastics for the eyes. Quite simple exercises help to maintain the tone of the eye muscles:

Stick a circle of red or black paper with a diameter of 5 mm on the window glass and from a distance of at least 30 cm, either with the right or with the left eye (closing it with the other palm), look at the circle itself, then into the distance.
“Write” a figure eight with your eyes closed: from bottom to top, from left to right and diagonally.
“Clamps” in the neck also affect vision, so you can do this exercise: imagine that the nose is a pencil, and try to write your name with such a pencil or “draw” something, for example, a house, a flower or any other object.

Myopia of the 1st degree during pregnancy usually does not create problems and any restrictions for childbirth. The same applies in most cases to myopia of the 2nd degree during pregnancy. However, in any case, a woman in position should be very careful about her body, because all the troubles that happen to her at this time are reflected in the baby.

Eyes and vision must necessarily be under the close attention of the future mother, because only with the help of vision a woman is able to see the smile of her newborn child.

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During pregnancy, various health problems can worsen in women, because the body is exposed to increased stress. If a girl wants to endure and give birth to a healthy child, and also not to harm her well-being, then she must definitely be examined by a doctor. It is important to check visual acuity, as well as to identify pathologies, if any. It is not uncommon to have mild myopia that occurs during pregnancy. It is necessary to monitor the development of the disease, because with progression, a caesarean section may be required.

Symptoms of myopia during pregnancy

You can detect a problem with the eyes if you pay attention to alarm signals. Often, girls ignore them, because they have all the thoughts about the upcoming birth. At first glance, it may seem that vision problems are not dangerous, but they are not. Myopia can be significantly aggravated during childbirth, which is why there is a risk of even going blind. That is why it is important to notice the problem in a timely manner, as well as visit a medical specialist for diagnosis.

The main symptoms of myopia:

Decreased visual acuity when looking at distant objects.
The appearance of flies before the eyes. This visual hallucination often indicates a health problem.
Increased eye fatigue. Sometimes a few minutes of reading is enough to cause discomfort in this organ.
Blurring of objects, as well as the distortion of their forms.
The occurrence of bright flashes. This also indicates that the eyes are not all right.
Frequent pains in the head and eye sockets, as well as in the forehead.

During the period of gestation, various changes are observed in the body. Vision may deteriorate, so it is important to consult an ophthalmologist. This applies even to those women who previously had no eye problems. If you do not want to face a deterioration in well-being, then you definitely need to undergo an examination at the beginning of pregnancy.

Causes of myopia during pregnancy

The heart and blood vessels during the period of bearing a child suffer from increased stress. That is why intraocular pressure can increase, which negatively affects the state of the organ. This process is reversible, but it is important to monitor the ongoing changes. An increase in metabolism, as well as blood volume, is often associated with the formation of fetal blood flow.

If we talk about the progression of peripheral retinal dystrophy, then this process is not fully understood. However, it often provokes a rupture or detachment of the retina.

When a woman has myopia, then the pressure inside the eyes decreases. Because of this, the ciliary body does not receive enough nutrients, which leads to a disorder in the regulation of eye hydrodynamics. This happens not only during a difficult pregnancy, but also during the normal course of this process. This is due to the fact that there is a spasm of arterioles, due to which the cerebral and central blood circulation is distributed in a new way.

During the period of gestation, additional risks may appear, leading to myopia:

During the third trimester, tissue elasticity increases. If a girl has myopia, then her course may be aggravated. Of the severe complications, detachment of the retina can be distinguished.
If a girl is faced with severe toxicosis, then myopia can begin to actively progress. Visual function deteriorates to 5 diopters. This is due to the fact that the permeability of the lens capsule for water increases. Puffiness, curvature begins, due to which the refractive power increases.

Among the usual causes that provoke the occurrence of myopia, one can single out poor heredity, increased stress on the visual organ, and craniocerebral injuries. In any case, it is important to regularly consult a doctor, because during pregnancy, even myopia of the 1st degree can create many problems, as it begins to develop.

Degrees of myopia: what is the risk of caesarean section

Nearsightedness can vary in severity, and it is important to determine the specific stage. Depending on this indicator, the doctor will decide whether to send the woman for a caesarean section or not.

First. Deterioration of visual function is not more than 3 diopters.
Second. Vision fell by 3-6 diopters.
High. Visual function deteriorated by 6 diopters or more.

If a girl has the first degree, which is not prone to progression, then this will not be reflected in the method of childbearing. Childbirth will take place naturally, if there are no other contraindications.

There are also situations when a diagnosis of "non-progressive moderate myopia" is made. In such a situation, a girl can also give birth on her own, because the risk to health is minimal.

It is noteworthy that earlier, in the third degree, a woman was sent for a caesarean, but now this is happening less and less. Hemorrhages in the retinal area, as well as retinal detachment, can occur even in a healthy patient. At the same time, the likelihood of such a complication is not directly related to myopia. In any case, the girl will need to undergo a diagnosis in order to understand if there are any obvious contraindications for natural childbirth.

If a woman has mild retinal dystrophy and myopia of the third degree, then most often you can give birth on your own. With an obvious dystrophic process, it is necessary to analyze the size of the pelvis of the woman in labor, as well as the weight of the fetus, in order to understand exactly how delivery should occur.

Detachment after surgery on one eye is considered a clear indication for caesarean section. Again, only a doctor can unequivocally say whether a woman needs to be sent for surgery or not. It is often possible to give birth on your own without dangerous complications for visual function.

Treatment of myopia during pregnancy

It is best to start treating any chronic diseases after the baby is born. In this case, there are situations when therapy is required immediately. Laser photocoagulation of the retina is often used to treat myopia. This is a safe method for pregnant patients and can strengthen the retina. Thanks to this, it is possible to prevent the development of detachment of the retina and the dystrophic process of the eye.

The procedure is completely painless, so the woman does not have to worry about pain. It is important that there are no symptoms of preeclampsia, because this is a contraindication. After the blockade of the gap, you will need to visit an ophthalmologist every month. 30 days before the expected date of delivery, the doctor will assess the condition of the eyes and decide whether the girl can give birth on her own. If new gaps appear, then you will have to once again carry out laser exposure. With detachment, emergency surgery is indicated, which will preserve visual function.

Vision correction is a simple option for those patients who wish to see normally. They may use lenses or glasses throughout their pregnancy. You can decide for yourself which device is best suited, based on your feelings. It is recommended to take disposable lenses that do not need care to the maternity hospital. They are allowed to stay no more than 12 hours, and then they will have to be removed.

If a girl is in a special position, then she definitely needs to visit an ophthalmologist at least once. This is done from 10 to 14 weeks of pregnancy. The doctor will assess the condition of the fundus, and also decide if there are any diseases. If present, treatment or special recommendations may be required. Another examination is carried out a month before the birth, because it is important to make sure that there are no new problems with the eyes. If you carefully take care of your health, then there will be no complications, and the child will be born naturally.

At the end of the first trimester, all pregnant women will have to consult an ophthalmologist. Statistics say that every third woman carrying a child is diagnosed during the examination.

In general, the disease is not a contraindication to childbirth. But there are some situations when expectant mothers with reduced visual acuity will need a special approach. About how myopia proceeds during pregnancy, are there any risks for mother and baby, and how the disease will behave after childbirth, read on.

Possible risks of complications

The influence of pregnancy is experienced by all organs and systems of a woman, including the visual apparatus. Myopia (ICD code 10 - H52.1) during gestation carries certain risks associated with changes in the retina. With myopia, the eyeball changes its shape, which entails a thinning of the retina, especially its peripheral parts. During childbirth, intraocular pressure rises, the retina experiences an increased load, and in “weak” thinned places it can exfoliate.

REFERENCE! Retinal detachment - what is it? This is the separation of the retina of the eyeball from the vascular. Which can lead to a significant drop in vision.

Whether there will be complications with myopia during childbirth, no doctor can predict. Doctors can only assess the likely risks for a particular patient, which will depend on the degree of myopia:

As for the child, the risks for him are associated primarily with genetic prerequisites. Experts have proven that myopia is hereditary in nature and is transmitted both maternally and paternally. If both parents are diagnosed with myopia, then with a 50% chance the child will also be myopic.

Causes of weak myopia during gestation or childbirth

Decreased vision by 0.8-1.5 diopters over three trimesters, doctors tend to consider as a physiological norm that does not require therapeutic measures.

Why does visual acuity decrease during pregnancy:

fluid retention in the tissues changes the shape and thickness of the cornea;
the eyes are deficient in nutrients, most of which goes to the development of the fetus;
the elasticity of tissues that stretch the eye structures increases;
high blood pressure leads to disruption of metabolic processes in the tissues of the eye;
gestational diabetes (temporary gestational diabetes) affects the small blood vessels that supply the eye membranes with food and oxygen.

A drop in visual acuity to 5 diopters is most often caused by late toxicosis of pregnant women. High edema leads to changes in the lens capsule - it becomes more permeable to fluid. The lens itself is saturated with water and, increasing in size, changes its curvature and refracts the sun's rays incorrectly. The rays are focused in front of the retina, which is the basis for the development of myopia.

There are frequent cases of increased dryness of the eyes, which also cause difficulties with visual perception. This is due to excessively narrowed vessels that prevent the physiological secretion of the lacrimal fluid.

Special drops will help to fix the problem - with myopia, the ophthalmologist can prescribe artificial tears with a composition that is safe for mom and baby.

Doctors say that in most cases visual acuity with mild myopia returns to normal after pregnancy. When all physiological factors cease to influence the structures of the eye.

IMPORTANT! Sometimes vision problems persist throughout the lactation period, and the severity is restored only when breastfeeding stops.

What determines the mode of delivery

The decision on how the birth will take place, whether a woman with myopia will be able to give birth to a baby herself, or whether a caesarean section is required, is made by a gynecologist in close cooperation with an ophthalmologist. Sometimes it is necessary to consult several doctors and conduct a consultation, where all risk factors are compared, taking into account the patient's condition, the presence of complications and common diseases.

The ophthalmologist during the examination takes into account not so much visual acuity as the condition of the fundus. Therefore, even if a woman has a high degree of myopia, but no dangerous changes in the structures of the eye have been detected, natural childbirth can be shown to a pregnant woman.

Caesarean section is prescribed in the following cases:

gross dystrophic changes in the retina, ruptures and detachments;
retinal detachment operated during pregnancy;
retinal detachment after surgery on a single eye.

It is not uncommon for the pre-prepared delivery tactics to change already during childbirth based on the current symptoms and the condition of the woman in labor.

What is better to take to the hospital - glasses or lenses

And, and glasses can be equally comfortable and appropriate in the hospital. It all depends on the personal preferences of the woman, her features and habits. Some people prefer to take only glasses with them to the hospital, as they do not require special care. Others cannot imagine life without contact lenses, giving unlimited freedom of action.

During the preparations for the maternity hospital, you can consider the purchase option. Disposable lenses are very comfortable to wear, at the same time there is no need to take with you, and other accessories inherent in reusable lenses.

Planning is an important step

Doctors keep insisting that the best pregnancy is planned. This approach allows you to comprehensively study the condition of a woman even before gestation, identify pathologies in time and take measures to eliminate them.

For example, diagnosed thinning of the retina can be easily treated with a laser. During the procedure, problem areas of tissues are spliced and sealed.

Women with diabetes, a tendency to high blood pressure or intraocular pressure will need to undergo a rehabilitation course. Taking special drugs will help compensate for violations and prepare the internal organs for the upcoming pregnancy.

Particular attention should be paid to nutrition - our eyes love low-carb foods with lots of vitamins.

ADVICE! In summer, ophthalmologists advise to consume more blueberries and gooseberries, in winter - carrots, bananas and apples. These fruits are rich in vitamins A and E, on which good vision depends.

Another important aspect is vitamin preparations. Vitamin B9 (folic acid) is considered the most useful for pregnant women. It contributes to the proper formation of the neural tube of the fetus. The further development of all sense organs, including the organ of vision, depends on it. You can take folic acid already at the planning stage - the gynecologist will tell you the exact dosage.

Do not forget about a healthy lifestyle in general. Quitting smoking and alcohol, good rest, regular walks in the fresh air, no heavy loads (both general and visual).

The factor of heredity

A child born to a nearsighted mother acquires additional visual risks. Parents need to take care of the regular diagnosis of vision in the baby. The first examination by an ophthalmologist should take place already in the first month after childbirth, another one at 6 months, and then annually. A young mother can go to an appointment with her baby. This will allow you to check your vision in a timely manner and at the same time monitor the health of the crumbs.

Useful video

Experts talk about the prevention of eye diseases during pregnancy:

A woman should report all vision problems to the gynecologist who leads the pregnancy. Floaters before the eyes, flickering, flashes of light, double vision and distortion. All this may indicate serious ophthalmic disorders that cannot be ignored. Only regular preventive examinations and the responsibility of the woman herself will make it possible to postpone childbirth with minimal risks, even with a high degree of myopia.