Effect of instrumental delivery on the frequency and severity of retinal hemorrhages in the newborn.

The frequency and severity of retinal hemorrhages were studied in 200 newborns within the first 72 hours of life. One hundred of the neonates were delivered instrumentally by either forceps (49 cases) or vacuum extraction (51 cases). Another hundred neonates were delivered spontaneously and served as controls. Both the highest and the lowest frequency of retinal hemorrhages were found among the babies delivered by instrumentation. The actual values were 50 per cent in the vacuum groups and only 16 per cent in the forceps group (p less than 0.01). The spontaneously delivered babies, who served as controls, showed retinal hemorrhages in 41 per cent of the cases. The frequency of severe retinal hemorrhages was five times higher in the vacuum group compared to both the forceps group and the control group (p less than 0.01, p less than 0.001).