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      Bilateral Exudative Retinal Detachment Complicating Preeclampsia With Partial Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome

      case-report
      Author(s): 1 , 2 ,
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: retinal detachment, hellp syndrome, pre-eclampsia, optical coherence tomography, pregnancy

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          Abstract

          Serous retinal detachment is an uncommon complication of pregnancy that occurs in well-known situations, such as severe preeclampsia, eclampsia, or hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. The latter still does not reach a consensus, in particular on its classification and pathophysiology. We report the case of a young pregnant woman having a partial HELLP syndrome with massive proteinuria who presented a bilateral exudative retinal detachment having healed spontaneously after pregnancy termination and blood pressure control without requiring an ophthalmologic intervention.

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          Exudative Retinal Detachment.

          Radgonde Amer, Hilal Nalcı, Nilüfer Yalçındağ (2017)
          Exudative retinal detachment (ERD) develops when fluid collects in the subretinal space. The subretinal space between the photoreceptors and the retinal pigment epithelium is the remnant of the embryonic optic vesicle. In the developed eye the subretinal space is of minimal size, but it can re-open under pathological conditions that disrupt the integrity of blood-retinal barrier (BRB). Inflammatory, infectious, infiltrative, neoplastic, vascular and degenerative conditions may be associated with BRB breakdown and the sequential development of ERD. We elaborate on the pathogenesis and the differential diagnosis of ERD and specifically discuss the spectrum of diseases associated with ERD in uveitis clinics.
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            The prevalence of retinal and optical coherence tomography findings in preeclamptic women.

            Meira Neudorfer, Oriel Spierer, Maya Goder … (2014)
            To evaluate retinal and optical coherence tomography findings and establish their prevalence in preeclamptic women.
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              Partial HELLP syndrome: maternal, perinatal, subsequent pregnancy and long-term maternal outcomes.

              C. Aydin, Cemal Ark, Serdar Onur Aydin … (2014)
              Hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome, in its complete form, is associated with increased risk of maternal mortality and increased rate of serious obstetric complications, such as acute renal failure, hepatic failure, abruptio placentae, pulmonary edema, sepsis, hemorrhage and disseminated intravascular coagulopathy. To compare maternal and perinatal outcomes, we investigated the subsequent pregnancy outcomes and long-term complications of women with partial HELLP (pHELLP) and complete HELLP (cHELLP) syndromes. In this retrospective study, patients complicated with HELLP between the years 2002 and 2007 were analyzed. cHELLP syndrome was defined by the presence of all of the three laboratory criteria according to the Tennessee Classification System. pHELLP syndrome was defined by the presence of one or two features of HELLP, but not the complete form. Sixty-four patients had cHELLP syndrome and 67 had pHELLP syndrome. Maternal complications and neonatal outcomes of the indexed pregnancies were similar. The rate of blood product transfusion was significantly higher in the cHELLP group (P<0.0001). Twenty-eight patients within the cHELLP group and 26 within the pHELLP group had subsequent pregnancies with a mean interpregnancy interval of 2.9 ± 1.5 years and 2.4 ± 1.1 years, respectively. Elective termination of pregnancy (dilatation and curettage) was more frequent in the cHELLP group. Pre-eclampsia recurrence was higher in the pHELLP group than in the cHELLP group (7.1% vs 34.6%). Partial and complete HELLP syndrome are not distinct groups based on neonatal, long-term and subsequent pregnancy outcomes. They probably represent a continuum in the natural evolution of the same disease. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 8 September 2021
                Publication date (Electronic, collection): September 2021
                Volume: 13
                Issue: 9
                Electronic Location Identifier: e17825
                Affiliations
                [1 ] Ophthalmology, Central Military Hospital, Kouba, DZA
                [2 ] Faculty of Medicine, University of Algiers, Algiers, DZA
                Author notes
                Article
                DOI: 10.7759/cureus.17825
                PMC ID: 8500246
                SO-VID: b41c6926-b388-486f-970f-84f621a6d1f0
                Copyright © Copyright © 2021, Zebbache et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 8 September 2021
                Categories
                Subject: Obstetrics/Gynecology
                Subject: Ophthalmology

                Keywords: retinal detachment,hellp syndrome,pre-eclampsia,optical coherence tomography,pregnancy
                Data availability:
                Keywords: retinal detachment, hellp syndrome, pre-eclampsia, optical coherence tomography, pregnancy

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