„Няма нито един доклад в литературата, който да свързва отлепяне на ретината с раждането при страдащи от миопия жени. И все пак миопията се счита за индикация за цезарово сечение в някои европейски страни.“

According to the RCOG’s Clinical Queries service:

There were no systematic reviews or randomised controlled trials on the method of delivery for women with severe myopia. However, a number of relevant case studies were found.

One retrospective study (evidence level III) reported that

“There is not even a single report in the literature of a case that can connect retinal detachment and childbirth in myopic women. However, myopia is considered as an indication for cesarean section in some European countries.”

The paper goes on to say that “rates of cesarean section were similar in non-myopic, low-myopic, low-myopic [<5 diopters] and intermediary myopic [-5 to –7.75 diopters] group, and notably high in high myopic [8 diopters or more] group.”

A number of studies have investigated the effects of vaginal birth on women with myopia. Katsulov et al (evidence level III) describe seven cases of women with high myopia [up to 15 diopters] who delivered vaginally without any deterioration in vision. Prost3 (evidence level III) found in 46 patients “there was no progression of retinal changes and development of retinal tears, but in some patients retinal hemorrhages and macular edema were observed”. Neri et al (evidence level III) also found no degeneration in retinal defects in 50 women with myopia from 4.5 to 15.0.

Two studies looked at the use of epidural anaesthesia for women with myopia. Travkin et al (evidence level III) found that prolonged epidural anaesthesia normalised the hemodynamics of the ciliary tract and decreased the frequency of operative delivery from 21.8% to 1.3%. Babaev et al6 (evidence level III) also found that epidural anaesthesia was affective in decreasing vasoconstriction and both cerebral and ocular circulation improvement which resulted in no deterioration in myopia after delivery.

Source: http://www.rcog.org.uk/index.asp?PageID=2294

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