Hemorrhage from the Gravid Uterus 459 



duced. There may be but a single hemorrhage or it may recur 

 several times. In severe cases, the hemorrhage may prove fatal 

 to the mother. 



The causes must be referred to a rupture of some of the uterine 

 vessels, which may be due to the presence of a tumor or other 

 disease or, as is probably most frequently the case, to some trau- 

 matic injury. 



The prognosis of uterine hemorrhage in the pregnant animal 

 is usually very grave, alike for the mother and the fetus. 



The treatment will depend greatly upon circumstances. First 

 of all, we should secure the most absolute quiet possible in the 

 hope that the blood may form a thrombus and the hemorrhage 

 from the wounded vessels cease. Harms recommends an applica- 

 tion of cold water or of cooling mixtures or ice bags to the pos- 

 terior part of the abdomen in the vicinity of the uterus, by which 

 he hopes to favor the formation of thrombi. Ergot and hydrastis 

 Canadensis may be given internally as styptics, but their effect is 

 not always satisfactory. When the hemorrhage is very threat- 

 ening, it may be desirable to bring about immediate dehvery of 

 the fetus. We would have one or more of three objects in view 

 in bringing about the evacuation of the uterine cavity, i. We 

 may thereby save the life of the fetus, although not yet fully 

 matured. 2. We may cause the hemorrhage to cease spontane- 

 ously by permitting an involution or contraction of the uterus 

 when freed from its contents. 3. We may be enabled to apply 

 remedies, of a topical character, directly to the bleeding parts. 

 The method of bringing about evacuation of the gravid uterus 

 has already been discussed on page 428. The conditions here 

 demand the greatest possible celeritj' compatible with safety, 

 once the operation has been determined upon. We cannot 

 readily bring about prompt evacuation of the uterus in the cow, 

 because the cervix is so firmly contracted, but in the mare, with 

 the very dilatable os uteri, delivery can be brought about very 

 quickly. 



After emptying the uterus of its contents, cold water or as- 

 tringents may be injected into its cavity, or it may be packed 

 thoroughly with gauze saturated with astringents, such as alum. 

 Those astringents or styptics, like the persulphate or iron and 

 some others which are irritant, should not be applied, because 

 they tend to induce straining, which serves to cause the hemor- • 

 rhage to continue and defeat the practitioner's aim. 



