Pathophysiology of neonatal subconjunctival hemorrhage

Of 111 newborns examined, 33 had subconjunctival hemorrhage (SCHN). Three of 19 patients delivered by cesarean section and 30 of 92 newborns delivered by the vaginal route had SCHN. Perinatal factors including duration of membrane rupture, length of second stage of labor, maternal weight and weight/length ratio, maternal ingestion of anti-inflammatory drugs, gravidity, birth weight, and Apgar score did not differ significantly in the groups with and without SCHN. It is proposed that in the majority of cases SCHN is a consequence of elevated venous pressure in the head and neck produced by compression of the fetal thorax and/or abdomen by uterine contractions. Tight umbilical cord around the neck probably represents an additional mechanism for SCHN.