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April 9, 1955

Hemorrhage of Late Pregnancy

JAMA. 1955;157(15):1354. doi:10.1001/jama.1955.02950320084028

The major emphasis of this book is on rupture of the marginal sinus of the placenta as a cause of hemorrhage in late pregnancy. Although the Bartholomew group, of which the author is a member, began to write about this only a few years ago, the subject is not a new one. Reference was made to marginal sinus bleeding in 1839 by Jacqemier. Fish emphasizes that rupture of the marginal sinus is by far the most frequent cause of genital hemorrhage in late pregnancy and in labor. Among 5,806 consecutive deliveries after six months' gestation conducted by the author's group, there were 398 instances of hemorrhage. Among these 398 patients, marginal sinus bleeding was the cause in 191, whereas placenta previa was the cause in only 94, and abruptio placentae in only 40. The total fetal mortality for the marginal sinus series was 4.1%; for the placenta previa series 7.5%,

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