Stolp W, Kamin W, Liedtke M, Borgmann H
Gyn.-Geburtsh, Abteilung, Johanniter-Krankenhauses Bonn.
Geburtshilfe Frauenheilkd. 1989 Apr;49(4):357-62. doi: 10.1055/s-2008-1026600.
The possible significance of subconjunctival bleedings (hyposphagmas) as a symptom for other pathological changes of the eye was studied in a group of 354 postpartum patients. They were found in 10.5% of the cases. A relatively higher frequency occurred in primiparas. No other maternal factors than parity were detected as of statistically significant influence. A slightly higher percentage in mothers with large newborn (above average cranial circumference) indicates a relationship to the necessary bearing-down effort. In a second study, 49 postpartum women with subconjunctival bleeding were examined by an ophthalmologist. Neither any intraocular or retrobulbar bleeding nor any other grievous damage to the eye were found. In accordance with the literature we recommend, that highly myopic pregnant women (even with a previous history of retinal detachment, but ophthalmologically sufficiently treated) should undergo induced delivery. However, the approach to pregnant women with retinal detachment occurring and treated during pregnancy, or to glaucoma-patients with risk to a small remaining visual field, should be more careful. In those cases, a vaginal operative delivery procedure (forceps, vacuum-extraction) is recommended. Nevertheless, one should consider individual wishes of the mother, when striving to diminish the risk to the foetus. The same applies to irrational fears related to previously damaged (and possibly only functional) eye.
在一组354名产后患者中，研究了结膜下出血（结膜下积血）作为眼部其他病理变化症状的可能意义。在10.5%的病例中发现了结膜下出血。初产妇中出现的频率相对较高。除了产次外，未发现其他母体因素具有统计学上的显著影响。新生儿较大（头围高于平均水平）的母亲中结膜下出血的比例略高，这表明与分娩时必要的用力有关。在第二项研究中，49名有结膜下出血的产后妇女接受了眼科医生的检查。未发现任何眼内或球后出血，也未发现眼部的任何其他严重损伤。根据文献，我们建议高度近视的孕妇（即使有视网膜脱离病史，但眼科治疗充分）应接受引产。然而，对于孕期发生视网膜脱离并接受治疗的孕妇，或视野残留较小有风险的青光眼患者，处理时应更加谨慎。在这些情况下，建议采用阴道手术分娩程序（产钳、真空吸引）。不过，在努力降低对胎儿的风险时，应考虑母亲的个人意愿。这同样适用于与先前受损（可能仅为功能性）眼睛相关的不合理恐惧。
