Retinal and conjunctival haemorrhage in the newborn.

Two hundred and thirty newborn infants were examined for retinal and conjunctival haemorrhages. Retinal photographs were taken in selected cases to record the morphological varieties and the different rates of disappearance of the retinal haemorrhages. The incidence of retinal and conjunctival haemorrhages was studied in relation to a number of possible aetiological factors. In the case of retinal haemorrhages we did not identify the critical factor or factors that determine their occurrence. Neither cephalic venous congestion, nor a coagulation defect, nor birth asphyxia was associated with retinal haemorrhages. It is likely that they are of multifactorial origin, and it is suggested that blood viscosity may be an important contributory factor. In contrast, conjunctival haemorrhages occurred in association with multiparity, rapid second stage of labour, Negro race, high Apgar score, and relatively high birthweight, head circumference, and gestational age. In addition the occurrence of conjunctival haemorrhage as part of the picture of `traumatic cyanosis' suggests that these lesions do result from changes in cephalic venous pressure.