Laser coagulation of retina in female patients with diabetic retinopathy allows to save pregnancy

<jats:p>Aim. To evaluate the effectiveness of retinal laser coagulation (RLC) in pregnant women with diabetic retinopathy (DR) and its impact on obstetric tactics and the formation of indications for premature termination of gestation. Material and methods. 49 pregnant women with type 1 diabetes mellitus (T1DM) and progression of DR (34 with proliferative (PDR), 15 with preproliferative), including 5 patients with diabetic macular edema, underwent standard and in-depth (with optical coherence tomography-angiography) ophthalmological examination in three trimesters of pregnancy and 1, 3, 6, 12 months after delivery. During gestation and after delivery, patients underwent panretinal laser coagulation (PRLC), focal RLC, and after delivery, if necessary, endovitreal intervention (EVI) and anti-VEGF therapy. According to the medical records, gestation outcomes were analyzed in patients included in the study. Results and discussion. Conducting RLC during gestation allowed stabilizing the course of DR before delivery in 78% of patients. DR progression continued after delivery in 11 patients, in connection with which they underwent expansion of RLC zones, anti-VEGF therapy or EVI, which ensured stabilization of the course of DR and preservation of high visual acuity. In 82% of women, delivery occurred by cesarean section at 36±1 weeks of pregnancy due to fetal hypoxia, preeclampsia and progression of diabetic nephropathy. Nine pregnant women (18%) gave birth naturally at 38-39 weeks of gestation. In our study, in no case was there a need for artificial abortion for ophthalmological indications, despite the progressive course of DR in patients. Also, there were no ophthalmological indications for labor management with the exclusion of the pushing period. Clinical practice shows that by performing timely PRLC in a pregnant woman with DR, it is possible to minimize ophthalmological indications for cesarean section. Conclusions. 1. In 78% of pregnant women with progression of DR included in the study, PRLC performed during gestation stabilized the course of retinopathy. 2. Progression of PDR can be excluded from the indications for premature artificial termination of gestation with timely PRLC in pregnant women with T1DM. 3. Performing RLC in case of progression of DR during pregnancy reduces ophthalmological indications for cesarean section in patients with T1DM.</jats:p>