Haemorrhage from the uterus before and after labour

• Main Author: Balfour, Tom Stevenson
• Published: University of Edinburgh 1893
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.734537

Hasmorrhage during or after labour is one of the most trying accidents connected with the subject of Obstetrics; whether it occurs before the birth of the Child, or after, when its sudden onset, just as labour seems to be happily terminated, and its alarming effect on the patient, tax the resources of the Obstetrician to the utmost and necessitate the possession by him of the military qualities, calmness and coolness in danger. Some idea of the importance of this subject may be gathered from the Registrar-General's report. Thus in five years, 1871-1875, $524 deaths were return? ed as due to "flooding" .?*?' In the year 1871 there was a population in England and Wales of 22,712,266 and in London of 3,254,260 ot* a total of 25,966, 526.2) The death rate during this time was 22 per 1000 per annum,?' or a total death-rate for the five years of (roughly) 2,856,260. By Calculations we can now see that one death in every 800 odd is due to flooding. Similarly, taking the birth-rate as 35 per 1000 per annum1' we get a total birth-rate of 4,544,050 and a proportion of One death due to flooding in every 1,289 labours. It must be remembered that these figures show only the actual deaths due to this complication, and it is probable that only post partum haemorrhage is includ? ed under the term"flooding"; cases of Placenta Praevia etc. being returned under other heads. I know of no statistics that show the number of people who actually suffer from haemorrhage , not of so severe a degree as to cause death, nor the amount of illness and misery caused by this complication. The difficulty a student or young practitioner has in treating cases of severe haemorrhage is much in? creased by the habit obstetrical books have of looking on Uterine Haemorrhage as a different thing from ordin? ary surgical haemorrhage and entailing a special treat? ment. But I don't think this is the case at all. The ne treatment of Uteris haemorrhage rests on the same broad principles as that of ordinary surgical haemorrhage , and differing only in being applied to a special place.