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Q: Birth Plan Options - Detached Retina ( Answered,   3 Comments )
Subject: Birth Plan Options - Detached Retina
Category: Health > Women's Health
Asked by: pandemonium-ga
List Price: $100.00
Posted: 30 Oct 2002 11:47 PST
Expires: 29 Nov 2002 11:47 PST
Question ID: 93385
My wife had a detached retina repaired two years ago with a
combination of a "scleral buckle", which is a 15mm wide silicon strap
sewn around the rear of her eyeball and laser.

We are expecting our first child in late December and her doctor
indicated cesarean section due to risks associated with increased
interoccular pressure during vaginal delivery. He advised we consult
her eye doctor.

Her eye doctor has not provided clear guidance and no one has provided
data we can use to support a decision. We are torn between trusting
the advice of our doctors, while aware that fear of malpractice may be
guiding them to the least litigious delivery option.

Are any data available to support our decision? What are the risks,
pros and cons of each option?
Subject: Re: Birth Plan Options - Detached Retina
Answered By: journalist-ga on 30 Oct 2002 13:43 PST
Greetings!  Let me first preface my answer by declaring that I am not
a physician or opthamologist, nor am I a lawyer with experience in
physician malpractice cases.  That said, I will proceed with the
information I located regarding your query.

From an article from the web site
( there is
a sub-heading titled "Caesarean Section" about three-quarters down the
page.  In that area, there is the statement "Sometimes it may be done
to protect the mother if she has a heart condition, very high blood
pressure, pre-eclampsia, diabetes or a detached retina."

I found an article about Preeclampsia (high blood pressure) at
and how the condition may develop or increase during pregnancy. The
article states "One in 200 pregnant women who have preeclampsia will
go on to have eclampsia. The seizures of eclampsia are marked by
general abnormal electrical activity in the brain. Usually the
seizures start before the baby is born. However, about 20% to 25% of
the time, seizures begin within the first 24 hours after the baby is
born. A few women develop seizures later, up to 3 weeks after the

Described in the article is that a woman with eclampsia may have one
or many seizures.  One of the possibilities that may occur during a
seizure is listed as "experience a detached retina in the eye."  This
may also be a reason that the doctor is suggesting Cesarean section,
just to be safe.  I found similar concerns of detached retinas from
this condition mirrored on other medical sites such as

This, from Vision Web
states "Vision problems during pregnancy may signal other health
problems. Blurred vision or seeing spots may indicate gestational
diabetes or pregnancy-induced hypertension, an increase in blood
pressure that usually occurs after the 20th week of pregnancy.
Eclampsia and pre-eclampsia, caused by extremely high blood pressure,
can cause eye hemorrhages and retinal detachment, although these are
extremely rare."

Discovery Health (
also has a comprehensive article on the topic.

The online Merck Manual
( also covers a
topic in pregnancy concerning morning sickness and detached retinas. 
This is not directly related to your query but if the expectant mother
has had morning sickness, I believe this might be of interest to you.

About a third of the way down the above site page under the
sub-heading "Excessive Vomiting" is this: "If vomiting persists, the
liver may be damaged, sometimes rupturing and bleeding. Another
serious complication is bleeding in the retina of the eye (hemorrhagic
retinitis), caused by increased blood pressure during vomiting."

If the mother has had this, it may be the doctor is also taking into
consideration that it, coupled with a traditional delivery, could pose
a risk to the mother.

You did not mention if the mother is a diabetic so I have not included
those articles which referenced detached retinas in diabetic pregnancy
conditions. I am aware of the diabetic condition "gestational
diabetes" which can appear only during pregnancy and a good article on
that is available at

I will let you discern the risks, pros and cons after examining the
information I have provided.  From my viewpoint, it seems risky to opt
for a traditional delivery considering the mother's retinal problems
have already surfaced and been treated surgically.  If I were making
this choice for myself, I would choose a Cesarean delivery.  However,
there are risks associated with that procedure (see and so, ultimately, you and your
wife must weigh the information to make your informed decision.

I hope my research is helpful to you in making a determination on how
to proceed.  In searching, I drilled down the results of each search
to four or more pages of results to gather this information.  If you
would like more article links to diabetes and pregnancy/delivery,
please request a clarification for such and I will be happy to conduct
further research before you rate my answer.


detached retina pregnancy delivery
Cesarean Section detached retina
intraocular pressure pregnancy detached retina
detached retina pregnant
diabetes during pregnancy
retina problems during pregnancy delivery
retinal problems during pregnancy delivery
risks of Cesarean delivery
cesarean section risks
Subject: Re: Birth Plan Options - Detached Retina
From: jcg-ga on 30 Oct 2002 23:55 PST
Dear Pandemonium,

Congratulations on the coming family addition!  A close friend of mine
(Dr. Klaus Lucke) is one of the top ten retinal surgeons in the world.
 He has a large clinic in Germany.  If you send him your question by
e-mail ( he will likely provide you an answer.  Tell
him JG said to mail him.  Best of luck.

Subject: Re: Birth Plan Options - Detached Retina
From: jcg-ga on 31 Oct 2002 12:57 PST
Dear Pandemonium,

Dr. Lucke's website is  In the group picture, he is in
the center of the front row.  He built the clinic from the ground up. 
He's brilliant and is also a nice person.  He will give you a solid

Subject: Re: Birth Plan Options - Detached Retina
From: doulakellie-ga on 02 Nov 2002 19:17 PST
Another aspect to consider - One would assume that the doctor's
concern stems from the pressure to the eye during the second stage of
labor (pushing).  If your wife does NOT have an epidural, she will be
able to more effectively push her baby out without "purple pushing",
which is taking a big breath and holding it while pushing.

If you two decide to go ahead with a vaginal birth, I strongly
encourage you to hire a doula and prepare effectively through
childbirth classes such as the Bradley Method.  A great book for
learning about your options is "The Thinking Woman's Guide to a Better
Birth" by Henci Goer.  Helpful books on childbirth are:  "Natural
Childbirth the Bradley Way", "Mind Over Labor" and "The Birth

Best wishes to you!

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