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Research implications

  • The included studies are of a high quality and address this subject comprehensively.  However, further studies documenting the rate of resolution of haemorrhages would be of benefit
  • While there is a clear association between a vacuum or double instrumental delivery and retinal haemorrhages, it is impossible to discern how much of this relationship relies on the pressures applied to the infant skull, and how much is a consequence of the obstructed labour requiring instrumental intervention
  • While subdural haemorrhages have been recorded as a consequence of delivery, it is unfortunate that no study has been conducted examining the coexistence of subdural haemorrhages and retinal haemorrhages in the newborn
  • There is a need for an internationally agreed recording of retinal haemorrhages in children


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