Blindness associated with preeclampsia and eclampsia

F. G. Cunningham, C. O. Fernandez, C. Hernandez

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Objective: Over a 14-year period at Parkland Hospital, the clinical courses of 15 women with severe preeclampsia or eclampsia were further complicated by blindness. Our purpose is to describe their management and outcome, as well as to offer insight to the pathophysiologic characteristics of blindness complicating pregnancy-induced hypertension. Study design: Prospective ascertainment of women with blindness and pregnancy-induced hypertension was done. These cases were managed according to the standardized preeclampsia-eclampsia regimen used at our hospital since 1955. Briefly, this regimen includes magnesium sulfate given intramuscularly to prevent or control seizures, hydralazine to lower dangerously elevated blood pressure, intravenous fluid restriction, and delivery. Results: There were 15 women with blindness that persisted from 4 hours to 8 days; it subsequently resolved completely in all. Of the 13 women who underwent computed tomography, 8 had low-density areas localized predominantly in the occipital lobes. Five of these 13 subsequently underwent magnetic resonance imaging and 2 showed corresponding hyperintense lesions in the occipital areas. Conclusions: On the basis of previously published experiences with computed tomography in women with eclampsia, as well as the experiences described here, we conclude that cortical blindness associated with preeclampsia-eclampsia results from petechial hemorrhages and focal edema in the occipital cortex. These lesions are likely stimulated by disparity in cerebral regional blood flow that is characterized by vasospasm and diminished flow primarily affecting the posterior circulation.

Original languageEnglish (US)
Pages (from-to)1291-1298
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume172
Issue number4 I
StatePublished - 1995
Externally publishedYes

Fingerprint

Eclampsia
Blindness
Pre-Eclampsia
Occipital Lobe
Pregnancy Induced Hypertension
Cerebrovascular Circulation
Tomography
Cortical Blindness
Hydralazine
Magnesium Sulfate
Regional Blood Flow
Edema
Seizures
Magnetic Resonance Imaging
Prospective Studies
Hemorrhage
Blood Pressure

Keywords

  • Blindness
  • Computed tomography
  • Eclampsia
  • Magnetic resonance imaging
  • Preeclampsia

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Cunningham, F. G., Fernandez, C. O., & Hernandez, C. (1995). Blindness associated with preeclampsia and eclampsia. American Journal of Obstetrics and Gynecology, 172(4 I), 1291-1298.

Blindness associated with preeclampsia and eclampsia. / Cunningham, F. G.; Fernandez, C. O.; Hernandez, C.

In: American Journal of Obstetrics and Gynecology, Vol. 172, No. 4 I, 1995, p. 1291-1298.

Research output: Contribution to journalArticle

Cunningham, FG, Fernandez, CO & Hernandez, C 1995, 'Blindness associated with preeclampsia and eclampsia', American Journal of Obstetrics and Gynecology, vol. 172, no. 4 I, pp. 1291-1298.
Cunningham FG, Fernandez CO, Hernandez C. Blindness associated with preeclampsia and eclampsia. American Journal of Obstetrics and Gynecology. 1995;172(4 I):1291-1298.
Cunningham, F. G. ; Fernandez, C. O. ; Hernandez, C. / Blindness associated with preeclampsia and eclampsia. In: American Journal of Obstetrics and Gynecology. 1995 ; Vol. 172, No. 4 I. pp. 1291-1298.
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