The management of labor in high myopic patients

The routine in our department for years used to be: prevention of bearing down during the end of the 2nd stage of labor in high myopic parturients, by forceps delivery, with the assumption that this will prevent increased intraocular pressure--thus preventing deterioration or increased damage to the eyes. The goal of this study was to challenge our theory and thus we decided to re-evaluate this approach. Various obstetrical data were recorded in 50 women with myopia from 4.5 to 15.0 diopters who were admitted in labor to our department. Fundus examination was performed in all of them before and after delivery. Various types of retinal degeneration and retinal breaks were observed in most of them at their arrival but no deterioration of these retinal defects was observed in any of the cases at the later examination. In view of our results, it is recommended to let high myopic patients deliver spontaneously.