A Case of Partial Placenta Prævia with Arm Presentation

pregnancy. The labour commenced in the evening. At first everything seemed to be going alright. The pains grew in intensity as time passed on and the membranes ruptured after three or four hours from the commencement of labour. After the escape of the Liquor Amnii a sudden and severe hiemorrhage set in, the blood gushing out in large quantities at every contraction of the uterus. This continued for two or three hours without any progress of labour. The severe bleeding was already producing serious symptoms. The woman felt giddy. She had thirst, cramps in lower extremities and was profusely perspiring. She was no longer able to sit the usual posture adopted by Indian women during labour?the pains stopped completely and the woman lay in a pool of blood quite exhausted and answering only loud calls. At this stage I was sent for. On seeing the woman, I found her pulse very weak and all the symptoms present of a severe liamiorrhage, P. V. Examination revealed the following things. The elbow was presenting. The os was dilated to its full degree and the placental end of the cord with a portion of detached placenta was distinctly felt at the upper part of the cervix. It was evidently a case of arm presentation with a partial placenta prsevia. When the membranes