CHAPTER XV
COMPLICATIONS IN LABOR (Cont’d)
Vomiting in labor frequently occurs near the end of the first stage. It is due to the sympathetic excitement of the nerves of the stomach as the last fibers of the os uteri give way. It requires no treatment.
Hyperemesis in labor is very rare, but when it does occur, the delivery should be expedited.
Hæmorrhages may occur either before, during, or after labor. Hæmorrhage is always serious.
Hæmorrhage before labor arises either from a premature detachment of a normally implanted placenta or from placenta prævia. The first is sometimes called “accidental hæmorrhage” to distinguish it from the latter, or “unavoidable hæmorrhage.”
Accidental hæmorrhage may be the result of an injury or a blow, but in many cases, there is no such history. The hæmorrhage is most frequent in the later months of pregnancy, and may be without any apparent cause. The hæmorrhage may be entirely inside the uterus (concealed hæmorrhage) or it may appear externally.
The hæmorrhage, when concealed, takes place back of the placenta or between the membranes and the uterine wall. If the hæmorrhage is concealed, it is usually followed by an attempt to expel the child. If the hæmorrhage is pronounced, systems of shock appear.
The diagnosis is made by the symptoms which are summarized in differentiating this condition from placenta prævia (p. [231]).
From this affection, nearly all the children and half the mothers die.
