RETENTION OF THE SECUNDLNES. This is the most frequent complication of abortion, spontaneous or criminal, and may present either of the following characters: The placenta is non-adher ent, but remains within the uterine cavity until finally expelled, either en tire, or in pieces. As infection easily occurs in such a case, great attention should be paid to the temperature. The placenta remains completely adherent. When this is the case the placenta is expelled only some days later, as late even as thirty days after delivery of the foetus.
[According to some authors, the pla centa may be absorbed and no expul sion occur. This opinion cannot any longer be admitted. When the placenta remains for years in the uterine cavity without producing alarming symptoms it is likely to become transformed into a mole. A. LUTAUD.] The placenta is partly adherent and partly non-adherent. This is the most dangerous condition, as it is the most liable to be accompanied by haemorrhage or septicaemia. Great care should be taken in such a case not to pull on the placenta, lest more liniorrhage be pro duced by further detachment.
An entire placenta in the uterus is not dangerous, but fragments rapidly give rise to grave symptoms. Bureau (Jour. de .116d., Apr. 3, '92).
Tetanus after abortion. The latter occurred during the third month. The uterus was properly cleared. but on the ninth day the temperature rose. then fell after an injection of collargolin.
Trismus was observed on the next day. followed by tetanus, which grew worse till the fifteenth day. Numerous in jections of Behring's tetanus antitoxin were administered, and recovery fol lowed. Osterlob (Monats. f. Gel]. u. Gyniik., Aug., 1902).
ILEMORRHAGE.—Hannorrhage may oc cur during the detachment of the ovum itself, during the detachment of the pla centa immediately after delivery of the foetus, or during detachment of the pla centa, the latter occurring several days after delivery of the fcetus.
The blood may be normal and be at once expelled from the genital organs; or it may form a half-coagulated mass within the vagina. Masses of fibrin in the blood should be diagnosed from the ovum itself, for which they may be mis taken.
The symptoms are those of all forms of hmmorrhage. When profuse there is a weak pulse, pallor, disturbances of hearing and sight, and vertigo.
The danger from the Inemorrhage is not so great as the general symptoms would often indicate; still, any serious loss might diminish resistance to infec tion.
Cases of luemorrhage before miscar riage, indicating the advisability of rap idly bringing the abortion to an end when the loss of blood is serious. Martin (N. Y. Med. Jour., Feb., '92); Blood (Chicago Med. Times, Aug., '92); Hirst (Amer. Gyn. Jour., Feb., '92).