Annual report : 1934 / Society of the Lying-in Hospital of the City of New York.
- Society for the Lying-In Hospital
- Date:
- 1934
Licence: Public Domain Mark
Credit: Annual report : 1934 / Society of the Lying-in Hospital of the City of New York. Source: Wellcome Collection.
43/60 page 39
![History No. 41516—Premature separation of the placenta. Patient, age 32, colored, para 5-1-2-3, Wassermann negative, pelvis normal. Was first seen in the Berwind Clinic in 1933, and referred to the New York Hospital because of a toxemia. Patient had a spontaneous abortion. Toxemia diagnosed as chronic nephritis. Patient registered again in March 1934, expected date of delivery July 27, 1934. Study of toxemia was made in hospital. Diagnosis was toxemia unclassified. On June 24, 1934, patient was again admitted because of onset of mild labor pains. On the morning of the following day pains became severe; foetal heart could not be heard; vaginal bleeding occurred. Bleeding was fresh blood, not clots. Uterus did not seem to relax. Hemoglobin, which was 82% on admission, fell to 52%. Possibility of premature separation of the placenta was considered. That afternoon a sterile vaginal examination was done to rule out placenta praevia; no evidence found. Membranes were ruptured artificially. A Voorhees bag was inserted. A varicosity of the labia was ruptured at this time, and about 500 cc. of blood lost before bleeding was controlled by a suture. The patient’s condition was poor. She was given a transfusion of 500 cc. The blood pressure rose to 60/40. Another transfusion was given a little later. The vagina was packed. Blood pressure never rose, and condition became steadily worse. Death occurred at 11 p. m. of the same day. Diagnosis: Premature separation of the placenta. Autopsy: Premature separation of the placenta. Pulmonary congestion, right lower lobe. Small subendocardial hemorrhages. History No. 62622—Postpartum hemorrhage, internal. Mother, age 31, white, para 1-0-0-1, generally contracted typical pelvis and Wassermann negative, L.M.P. December 28, 1933. Patient referred to New York Hospital Dystocia Clinic from Berwind Clinic on April 19, 1934 because of pelvic mass and history of slight spotting. Diagnosis of pregnant uterus with myoma on left side was made. Patient went into labor spontaneously, admitted with membranes intact September 29, 1934. Fetal head was in left upper quadrant and breech in right iliac fossa. Membranes ruptured spontaneously and hand prolapsed into vagina. Braxton-Hicks version was attempted but failed. Fetal heart lost 1 hour after attempted version. Because of compound presentation, temperature of 37.8°C., and lack of uterine relaxation, Porro Caesarean section was done. Transverse incision was found to be through a myoma about 10 cm. in diameter. Myomata were enucleated. Infant was deadborn, weighing 3730 gm. and measuring 54 cm. in total length. Because of wide enucleation of myoma supravaginal hysterectomy was done. Blood loss about 500 cc.; sutures were placed with difficulty in uterine vessels because of edematous [39]](https://iiif.wellcomecollection.org/image/b31710979_0043.jp2/full/800%2C/0/default.jpg)
