Subconjunctival hemorrhage is a very common birth injury that appears as bright red patches on the newborn’s eye. It usually occurs naturally due to childbirth pressure and resolves on its own. However, understanding its symptoms, causes, and when to seek medical attention is crucial for ensuring proper care. Here are answers to frequently asked questions about subconjunctival hemorrhage during birth.
What Is Subconjunctival Hemorrhage?
Subconjunctival hemorrhage is a condition in which tiny blood vessels rupture beneath the conjunctiva, the clear tissue covering the white part of the eye. The pooling of blood causes a bright red or bloodshot patch on the newborn’s eye. Though it may look alarming, it generally causes no pain or vision changes and usually goes away on its own.
How Often Does Subconjunctival Hemorrhage Occur in Newborns?
Subconjunctival hemorrhage is quite common among newborns, especially those delivered vaginally. The incidence for babies delivered by vaginal delivery is up to 46.3%, and over 92% of all babies who experience subconjunctival hemorrhage during childbirth were delivered vaginally.
What Causes Subconjunctival Hemorrhage During Birth?
Subconjunctival hemorrhage is common during childbirth due to the intense pressure exerted on the newborn as it passes through the birth canal. This pressure can easily rupture the delicate blood vessels beneath the conjunctiva, leading to visible blood spots on the sclera. The most common causes of subconjunctival hemorrhage during birth are:
- Pressure during labor: Strong contractions and the natural pressure from passing through the birth canal can lead to blood vessel rupture.
- Vaginal delivery: Babies delivered vaginally are more prone to subconjunctival hemorrhage due to the stress and compression on their bodies during the birthing process.
- Forceps or vacuum extraction: Assisted deliveries involving forceps or vacuum extraction can increase the risk of subconjunctival hemorrhage due to added pressure on the baby’s head. Improper use of these tools during delivery could be considered medical malpractice.
- Prolonged labor: Long, difficult labor may result in increased stress and pressure on the baby’s head, which can rupture blood vessels.
- Premature birth: Preterm infants have more delicate blood vessels than full-term babies.
- Maternal health conditions: Conditions like hypertension or diabetes can affect the delivery of the baby and increase the risk of complications like subconjunctival hemorrhage.
- Large baby (macrosomia): Larger infants may experience more significant pressure passing through the birth canal, increasing the likelihood of blood vessel rupture.
What Are the Symptoms of Subconjunctival Hemorrhage in Newborns?
Subconjunctival hemorrhage in newborns is usually easy to spot due to its distinctive appearance. The primary symptoms include:
- Red or bloodshot patches on the white part of the eye
- No swelling around the eye
- Absence of pain or discomfort
- No changes in vision or responsiveness
- Painless, localized bleeding beneath the conjunctiva
How Is Subconjunctival Hemorrhage Treated in Newborns?
Subconjunctival hemorrhage in newborns usually does not require treatment, as it often resolves on its own within two to three weeks. The body’s natural healing processes reabsorb the blood trapped under the conjunctiva, gradually fading the red patch. Parents can monitor their baby’s condition to ensure there are no changes or worsening symptoms.
It’s always a good idea to consult a pediatrician to confirm the diagnosis and rule out any other potential complications. While the appearance might be concerning, the condition generally does not affect the baby’s vision or cause long-term problems.
How Is Subconjunctival Hemorrhage Diagnosed in Newborns?
Subconjunctival hemorrhage in newborns is diagnosed primarily through a visual examination by a health care professional. The distinctive bright red patch on the white part of the eye usually makes the condition easily recognizable. The doctor will confirm that no swelling or other symptoms accompany the redness. In rare cases, additional tests may be conducted to rule out other underlying conditions, but the diagnosis is generally straightforward due to the visible nature of the bleeding.
How Does Subconjunctival Hemorrhage Affect Newborns?
Subconjunctival hemorrhage typically doesn’t cause long-term health issues in newborns and generally resolves on its own within two weeks. However, in rare cases, subconjunctival hemorrhage can indicate underlying issues like:
- Systemic hypertension: Uncontrolled high blood pressure could lead to more severe or repeated hemorrhages.
- Bleeding disorders: Persistent bleeding may point to an undiagnosed bleeding disorder.
- Systemic diseases: Conditions like diabetes, arteriosclerosis, or other vascular disorders can make blood vessels more fragile.
- Ocular tumors: Vascular tumors of the conjunctiva or other eye structures could be involved.
Is Subconjunctival Hemorrhage Preventable?
Subconjunctival hemorrhage is generally not preventable, as it often occurs due to natural causes and the pressure exerted during the birthing process. However, excessive or improper use of medical instruments like forceps or vacuum extractors during assisted deliveries can lead to this condition. Health care professionals assisting delivery must handle these tools carefully to minimize pressure on the baby’s head and reduce the risk of injury.
What Should Parents Do if They Suspect Subconjunctival Hemorrhage?
If parents suspect that their newborn has subconjunctival hemorrhage, they should:
- Consult a pediatrician: Schedule an appointment with a pediatrician or family doctor to examine the baby’s eye and confirm the diagnosis.
- Monitor the symptoms: Watch out for any changes or worsening of the red patches and document the progression.
- Rule out other issues: Work with health care professionals to identify any potential underlying conditions or risk factors that could cause recurrent hemorrhages.
- Follow medical advice: Adhere to the doctor’s guidance on managing the condition and ensuring proper care at home.
- Seek a specialist’s evaluation if necessary: If symptoms persist or worsen, consult an ophthalmologist or pediatric specialist for further evaluation and treatment options.
Can Parents File a Lawsuit for Subconjunctival Hemorrhage During Birth?
Parents can file a lawsuit for subconjunctival hemorrhage during birth if they can prove the injury caused pain and resulted from negligent behavior. However, this can be challenging since subconjunctival hemorrhage often occurs naturally and without lasting complications. To establish negligence, parents must prove these four elements:
- Duty of care: The health care provider had a legal obligation to provide competent care to the mother and newborn.
- Breach of duty: The provider failed to meet the expected standard of care through improper conduct or errors during delivery.
- Causation: The provider’s negligence directly caused or significantly contributed to the newborn’s subconjunctival hemorrhage.
- Damages: The injury resulted in pain and damages, such as medical expenses or long-term complications.
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