POST PAR TUM HjEMORRHA GE. 577 



CHAPTER II. 



Post Partum Haemorrhage. 



HEMORRHAGE from the uterus, or " flooding," after abortion, or the birth 

 of the foetus at the ordinary term — an accident so frequent and alarming 

 in woman — would appear to be far from common in the domesticated 

 animals. This difference between the female of the human species and 

 that of animals, is evidently due to the dissimilarity in organization of 

 the uterine mucous membrane in them, particularly at the insertions of 

 the placenta foetalis ; as well as to the absence of those immense vascu- 

 lar lacunas which exist in the uterus of woman, the walls of which are so 

 thin and fragile as to be easily torn when the placenta is detached, and 

 which renders insufficient contraction of the uterus after delivery such a 

 grave matter. Another reason for the unfrequency of metrorrhagia in 

 the veterinary obstetrist's patients, is the great rarity of placenta pravia 

 in them,* and which is a somewhat common cause of liEemorrhage either 

 during or after delivery in woman. 



Nevertheless, whether owing to some anatomical or pathological pecu- 

 liarity, to atony of the uterine walls, rupture of vessels during removal 

 of the foetal placenta, or even during its spontaneous expulsion, almost 

 every practitioner of any experience has met with cases of metrorrhagia 

 of a more or less alarming character. So serious, indeed, is this hae- 

 morrhage, that the mortality has been estimated as high as 73 per cent, 

 of the cases reported. 



We have already, at page 190, alluded to metrorrhagia occurring dur- 

 ing pregnacy. In what Cox has designated " pre-placental presentation " 

 {Veterinary journal, March, 1877, p. 178), we may have haemorrhage en- 

 suing. According to this authority, such presentations are rare, and if 

 they occur at the termination of gestation, may be looked upon as un- 

 favorable ; though they are most frequent in cases of abortion, and are 

 then seldom followed by serious results. Metrorrhagia ensues when the 

 usual period of parturition has been exceeded, and the " water-bag " has 

 been presented and ruptured, the entire placenta foetalis coming away 

 before. the foetus itself. " In some cases a considerable portion of the 

 membranes envelope the fore-parts of the foetus, and occasionally to 

 such an extent as to retard delivery ; this may be shredded off and re- 

 moved without risk, but it will be found that the posterior part remains 

 attached. The fatality attendant upon these cases is owing to neglect of 

 examination and proper aid, and this negligence is owing to the absence 

 of 'pains.' After the removal of the foetus, it is found that haemorrhage 

 has taken place from the open vessels, and the quantity indicates that it 



*Yx?cnc\i{Handbtich de Thierarztlichen Geburtshiilfe, and Zeitshrift fur T/ieirmedictn)\\Z5 clearly 

 demonstrated the occurrence of placenta prjevia in animals. Grey {Veterinarian, vol. xxvi., p. 12) gives 

 two instances of what he believed to be this condition. A farmer, in passing through a field in which 

 Cows were grazing, came upon a newly-expelled placenta, and knowing that one of the animals was in 

 calf, and near parturition, he returned to his farm, and gave directions that the calf should be looked for, 

 as he could not find it in the pastures. Nothing of it could be discovered, however, and the Cow was 

 therefore driven home. While being milked, however, it began to show uneasiness, and to evince evident 

 signs of approaching labor. Grey was sent for, and he states: "On examining my patient, I found a dead 

 foetus with all four legs presenting, which was with the greatest difficulty extracted." The Cow lived. _ In 

 the second instance, he was called to attend a Cow which had expelled the foetal membranes, and exhibited 

 great uneasiness. " In this case, on making an exploration, I again found the foetus presenting in a false 

 position ; but, after a little manual dexterity, I was enabled to remove a dead calf of unusually large size." 

 The Cow survived. 



37 



