CLiNICAL SECTION

EDiTOR: Not too long ago, the most dreaded perhaps of all hemorrhagic complications in obstetrical practice was that following premature separation of the placenta. \Vhen fully under way it is a major emergency. A feeling existed that the hemorrhage involved more than the simple tearing and exposure of open blood vessels. Continuation of the hemorrhage even in the presence of what seemed to be adequate measures for its control, and excessive bleeding from fresh sites dtiring and after operations designed to arrest it, forced the conclusion that the uterine hemorrhage was the expression of a systemic disorder of hemostasis. Development and enlargement of this concept by Schneider, and Duncan Reid and his associates, hastened the early recognition of this clinical syndrome in its various guises, and provided ways for probing its mechanisms and eventually for effective control of the hemorrhage. The remarks that follow are the independent answers to Pertinent questions put to a grotip of workers familiar with these problems. We are indebted to Dr. Duncan Reid for help in framing the questions and selecting the partici a13ts. \Ve shall begin by asking: Under what obstetric conditions is a clotting defect responsible for excessive bleeding likely to be encountered? Are there any clotting deficiencies other than that due to defibrination which may develop in complications of pregnancy?