Fundus changes in newborns

In recent years, in the CIS countries, including Crimea, the birth rate has decreased and the number of pathologies among pregnant women has increased. According to statistics, kidney disease in pregnant women has increased more than 3 times, the number of late toxicoses has increased 1.3 times. Did this affect the condition of the fundus of newborns?

We examined and analyzed the condition of the fundus in 735 newborns. Newborns were examined 24-96 hours after birth using direct ophthalmoscopy. At the same time, changes in the fundus in the form of hemorrhages and angiopathy were observed in 23.4% of cases. According to the literature, this percentage varies and is 19–30%. We observed both subconjunctival and retinal hemorrhages only during vaginal delivery. No hemorrhages were found in any case after cesarean section or during premature birth. This confirms the theory that the cause of hemorrhages during natural childbirth is mechanical compression of the head and its configuration. In this case, cerebral circulation disorders, venous congestion in the retinal veins and cavernous sinus with increased intracranial pressure occur.

In case of premature birth due to the low weight of the fetus and the small size of the newborn's head, these changes are not observed. We observed a greater number of hemorrhages during the first birth (in 25.6% of cases); during repeated births, their number was much less (17.6%).

In addition, we examined the condition of the fundus of newborns born to mothers suffering from diseases leading to fetal hypoxia. With late toxicosis of pregnancy, the frequency of changes in the fundus was 27%, with anemia of pregnant women - 31%. In case of hypertension (hypertension, symptomatic arterial hypertension), retinal hemorrhages in newborns were not found in any case, but subconjunctival hemorrhages were present in 10 out of 15 cases, although angiopathic changes amounted to about 33%.