The treatment of antepartum hemorrhage

RIGVIEWS Tweedy: iion),

The 1921,

Treatment 1, 5.

AND

of Antepartum

119

ABSTRACTS Hemorrhage.

The

Clinical

Journal

(Lon-

The author reports 72 cases of accidental hemorrhage in 18,000 deliveries with He plugged thirty patients and insists that the only two deaths from bleeding. vaginal plug, as used at the Rotunda Hospital, is efficient and does check hemor&age by impeding the circulation of the uterine vessels. His contention has been strengthened by seeing the absence of pulsation in the uterine artelcies, at cesarean section, when pressure was made from below on the lateral fornix. The operation does have some dangers, and will cause pain and may even bring about shock. Ruptu.re of the membranes is not considered a contraindication. By such procedure the main blood supply is cut off and coagulation at the sinuses is promoted. He believes that hysterectomy has no place in accidental hem,orrhage. A. G. WILLIAMSON. Strecker, J.: Disturbanoes burtshilfe und GynXkologie,

in the Third 1923, lxii,

Stage 283.

of Labor.

Monatsschriftl

fiir

Ge-

During the last few years of the war, it was observed that the number of postpartum hemorrhages increased markedly, and also that many women succumbed to relatively small losses of blood. Unlike eclampsia which has returned to its pre-war figure, the number of postpartum hemorrhages has remained as high :as it was during )’ the author considers first, retention of the placenta for th.e war. As “disturbances 2 to 5 hours without bleeding; secondly, slow hemorrhage with retention of the placenta which requires manual removal; and thirdly, incomplete expulsion of the placenta.. The last caused the’ greatest trouble. In treating these patients it was found tiiat there were fewer febrile reactions when retained portions of the placenta were removed than when the patients were treated expectantly. Many of the latter patients continued to ‘bleed. He frequently used the method of injecting a solution into the umbilical vein to hasten separation of the placenta, but advises against its use where there is much hemorrhlage. Manual removal of the placenta in cases of hemorrhage :is preferable to other uncertain methods. J. P: GREENHILL. Sf?ides: Pituitrin stetrics, 1923,

in the Third xxxvi, 108.

Stage

of

Labor.

Surgery,

Gynecology

and

Obb-

Seides administered 0.5 C.C. of pituitrin at the beginning of the third stage of He is convinced that the results are such as to warlabor in 500 consecutive cases. rant its use as a routine, and maintains that it not only shortens the third stage, but makes such manipulations as ChedB’s maneuvers altogether superfluous. He claims to have noticed a definite diminution of the amount of blood lost postpartum, and that even the lochia were diminished to such an extent that he was able to get his patients out of bed earlier than usual. He believes that a single dose of pituitrin thus administered fa.ciliates indution of the uterus. In no case did the pituitrin cause retention of the placenta. 1:. E. WOBUS. Abelh,eim: xviii,

Postpartum 167.

Hemorrhage.

The

Medical

Journal

of S,outh

Africa,

1923,

Patience to sit by and allow the placenta to separate normally is the greatest single factor in the prevention of postpartum hemorrhage. The uterus should not be kneaded and pressed upon before placental separation is complete. CredB’s expression is only justified after the placenta has separated. In the praence o’f severe hemorrhage with the placenta still in sitil~ the authol