RETINAL HAEMORRHAGES IN THE NEWBORN Comparison of delivery by forceps and by vacuum extractor

Abstract

Retinal haemorrhages were studied in a consecutive series of 99 babies delivered by forceps, 94 delivered by vacuum extractor and 207 delivered spontaneously.The incidence of haemorrhages for spontaneously delivered was 27.5 O/o, for those delivered by forceps 38"/0, and for those delivered by vacuum extractor 64O/o. The incidence of haemorrhages in the group of vacuum extractions was significantly higher than among either the group of forceps extractions or the spontaneous deliveries. I n addition, more severe haemorrhages were found in the group of vacuum extractions. Influence on the incidence of haemorrhages by factors other than type of delivery could not be verified statistically.

Ocular pathology in shaken baby syndrome and other forms of infantile non-accidental head injury

“…Usually, most RH in newborns are completely resolved without any sequelae by 8 days after birth [29,57,113], whereas NAHI-associated RH will persist usually for months [79]. Association to mode of birth delivery has been reported with the highest frequency for vacuum delivery, followed by vaginal delivery with or without forceps and least often in cesarean section [25,29,57,71,97,107] although this still remains controversial [7]. One study found a higher frequency of RH in neonates following dinoprostone-induced labor when compared with oxytocin [106].…”

Birth by vacuum extraction delivery and school performance at 16 years of age

“…Retinal hemorrhage has been shown to be related to VE, with an incidence of 49% (62) but with no long-term effects on the child (77,78). Infants delivered by VE are also at a higher risk of neonatal jaundice, (79) skull fractures (80)(81)(82)(83), and shoulder dystocia (84)(85)(86)(87).…”

Ocular features other than retinopathy of prematurity in the pre‐term infant

“…In the newborn retinal haemorrhages are quite common immediately after birth, in particular if delivery was sustained andfor required vacuum extractor or forceps (Duke Elder & Dobree 1967; Ehlers et al 1974;Mushin & Roberton 1986). Most haemorrhages are absorbed with a remarkable speed, and even massive sheet-like bleedings disappear within 5-7 days.…”