A 24-year-old G2P2 woman with type 1 diabetes and a past history of diabetic retinopathy presents with decreased vision and multiple new floaters in both eyes one week after an otherwise uncomplicated cesarean section. Examination revealed bilateral vitreous hemorrhages in the setting of proliferative diabetic retinopathy in pregnancy.
Which of the following statements regarding diabetic retinopathy (DR) in pregnancy is true?
A. Patients who are diagnosed with gestational diabetes are at an increased risk for developing DR during pregnancy
B. Patients with diabetes who develop DR during pregnancy (without prior diagnosis) have a low rate of spontaneous postpartum regression
C. Women with diabetes mellitus type I are at higher risk for progression to DR during pregnancy than those with type II
D. Patients with severe DR prior to conception have a lower risk of progression of disease during pregnancy
Correct answer: C
Option C is correct. Because diabetes mellitus type I has an earlier onset (and thus a longer duration prior to pregnancy) than type II, women with diabetes mellitus type I are at a higher risk for progression during pregnancy than those with type II. Option (A) Is incorrect, as those diagnosed with gestational diabetes during pregnancy are not at an increased risk for developing diabetic retinopathy. Women who develop diabetic retinopathy during pregnancy without a prior diagnosis have a high rate of spontaneous postpartum regression, making option (B) incorrect. The presenting patient had a previous diagnosis of diabetic retinopathy that was likely exasperated during pregnancy leading to hemorrhage. The final option (D) is incorrect as those with severe diabetic retinopathy prior to conception have a higher risk of progression during pregnancy.