- Objective: To evaluate the risk of retinal redetachment (RD) in women after vaginal delivery versus cesarean delivery (C-section) in patients with a history of RD.
- Methods:
- Retrospective cohort analysis of 66 deliveries from 32 women with a history of RD at a tertiary medical center (1990–2020).
- Patients were divided into two groups: vaginal delivery (40 deliveries) and cesarean delivery (26 deliveries).
- Primary outcome: Rate of retinal redetachment after delivery.
- Secondary outcomes: Maternal and neonatal outcomes.
- Results:
- Redetachment Rates: 5% (2/40) after vaginal delivery vs. 7.5% (2/26) after cesarean delivery (no significant difference, \( P = 0.654 \)).
- Time to Redetachment: 17 and 26 days for vaginal delivery vs. 5 and 30 days for cesarean delivery (no significant difference, \( P = 0.791 \)).
- Maternal and Neonatal Outcomes: No significant differences between the two groups in terms of gestational diabetes, preeclampsia, placental abruption, or neonatal outcomes.
- Discussion:
- No increased risk of retinal redetachment was observed after vaginal delivery compared to cesarean delivery.
- Historical concerns about Valsalva maneuvers during vaginal delivery leading to RD are not supported by current evidence.
- The study aligns with previous literature suggesting that vaginal delivery is safe for women with a history of RD.
- Discrepancies exist between obstetricians/gynecologists and ophthalmologists regarding the mode of delivery for women with ocular pathology, with many obstetricians favoring cesarean delivery despite lack of evidence.
- Conclusion:
- Vaginal delivery does not increase the risk of retinal redetachment compared to cesarean delivery in women with a history of RD.
- There is no ophthalmic benefit to recommending cesarean delivery for women with prior RD.
- The findings may influence clinical practice, encouraging vaginal delivery for women with a history of RD.
- Key Words: Retinal detachment, redetachment, mode of delivery, cesarean, vaginal delivery.