A survey of ophthalmologists and gynecologists regarding termination of pregnancy and choice of delivery mode in the presence of eye diseases

PURPOSE To evaluate and compare the attitudes of ophthalmologists and gynecologists in suggesting appropriate approach to pregnancy in different ocular conditions. METHODS Specialty-specific questionnaires on delivery mode and abortion indications for ophthalmic patients (refractive, vascular, oncologic, retinal, glaucoma, postoperation, posttrauma, and infectious) were designed and distributed among physician staff of Farabi Eye Hospital and Yas Women Hospital in Tehran. Attitudes and preferences of the ophthalmologists and gynecologists were quantified and compared. RESULTS Participants were 29 ophthalmologists and 19 gynecologists. Their mean age was 49.73 ± 7.57 and 46.79 ± 1.36 years, respectively. More than 50-70% ophthalmologists were in favor of normal vaginal delivery (NVD) in all ocular diseases. All gynecologists (100%) expressed their need for an ophthalmologist's opinion for decision-making. Ophthalmologists' top choices for conditions potentially requiring a caesarean section were corneal transplants (34.5%), high myopia (23%), retinal detachment (29%), and orbital tumors (34.5%), while two gynecologists recommended abortion in the presence of intraocular and orbital tumors and retinal detachment. In the case of a history of refractive surgery, orbital tumor and intraocular tumor, ophthalmologists recommend NVD over caesarean section twice as much as their gynecologist peers. For history of retinal detachment, glaucoma, retinal vascular accident and intraocular hemorrhage, no single gynecologist recommend NVD. The corresponding figure for ophthalmologist-recommended NVD were 67, 84, 72, and 81%. CONCLUSIONS There is extreme inconsistency among ophthalmologists and gynecologists in managing ophthalmic-obstetric scenarios, especially for caesarean section indications. Clinical guideline development and consultation for decision-making in challenging cases are recommended.