A textbook of obstetrics . -, is profuse andfrequently repeated, and in labor is more dangerous than is thehemorrhage of the lateral variety. There is an added difficulty,too, on account of the obstruction offered by the placenta, 1 Lchrbuch der Geburtshiilfe. 528 THE PATHOLOGY OF LABOR. stretched across the internal os, to the spontaneous descent of thechild, or to the physicians efforts to reach and extract it. Inlateral placenta praevia hemorrhage usually does not occur tilllabor is well advanced, and often does not appear at all. Lateraland marginal placenta praevia are the commonest varie
A textbook of obstetrics . -, is profuse andfrequently repeated, and in labor is more dangerous than is thehemorrhage of the lateral variety. There is an added difficulty,too, on account of the obstruction offered by the placenta, 1 Lchrbuch der Geburtshiilfe. 528 THE PATHOLOGY OF LABOR. stretched across the internal os, to the spontaneous descent of thechild, or to the physicians efforts to reach and extract it. Inlateral placenta praevia hemorrhage usually does not occur tilllabor is well advanced, and often does not appear at all. Lateraland marginal placenta praevia are the commonest varieties. In270 cases the placenta was marginal and lateral 217 times; cen-tral and partial 53 times (Winckel). Strictly speaking, centralplacenta praevia is very rare. There is almost invariably moreof the placenta on one side the internal os than on the other. -W1 B Fig. 404.—Varieties of placenta previa: in A there are seen the normal, lateral,and marginal implantation; in B there are represents! the implantation of the pla-centa at tin- fundus, which is rare, and implantation over the internal os ; in C lateralimplantation and that ol a cotyledon immediately over the internal os; and in I)partial implantation |1 )ickinson). Cluneal History.—A woman with placenta praevia may beginto bleed as early in pregnancy as the second month, but the fusthemorrhage usually occurs in the last trimester. There is a suddengush of blood, often without apparent cause and without bleeding commonly recurs in increasing amounts and at de-creasing intervals as pregnancy advances. In very rare casesthe blood leaks away continuously (stillicidium), though this is more characteristic of the premature separation of a normallysituated placenta. The cause of the hemorrhage during preg-nancy is the impact of the embryo and fetus upon the placenta,the pressure
Size: 1779px × 1404px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
