The successful management of hemorrhages of the parturient canal requires an intimate knowledge of their causes, unerring judgment, and immediate action for their prevention or control. It is important, therefore, to have in mind a well-developed plan of aggressive action in these emergencies; for on promptness and directness depend the safety of the mother and child.
These hemorrhages may occur before, during, or after labor. Those occurring before and during labor are either accidental or unavoidable. The accidental arc due to the partial separation of the placenta from its normal situation in the upper segment of the uterus on account of some pathologic state of the uteroplacental union or traumatism. The hemorrhage may be concealed, visible, or both. The concealed may be dependent on bleeding between the uterine wall and the placenta, the margin of the latter remaining attached; to extravasation of the blood between the membranes and the wall