Premature separation of the normally implanted placenta; a review of 306 cases.

Abstract 1.1. Most obstetric patients with premature separation can be delivered vaginally without increasing the maternal mortality. Evaluation in retrospect of the maternal deaths at the Cook County Hospital offers no improvement in results if cesarean sections could have been utilized. 2.2. The infant mortality is not increased by vaginal delivery. Cesarean section does not ensure a living baby as evidenced by a 22.2 per cent neonatal fetal mortality. 3.3. Indications for cesarean sections were:A. Maternal: (1) shock and/or persistent bleeding where vaginal delivery is not imminent. (2) cases where a completely damaged uterus is suspected.B. Fetal: In the presence of a normal, good-sized, living fetus with vaginal delivery not anticipated in a reasonable length of time. 4.4. Toxemia of pregnancy occurred in one-third of the patients with premature separation. The incidence of prematurity increased with the presence of toxemia. The severity of the premature separation increased with the severity of the toxemia. 5.5. Pituitrin appears to be a valuable adjunct in the treatment of premature separation.