Death from obstetrical hemorrhage.

Twelve hundred nineteen maternal deaths occurring from 1957 through 1966 in the State of California have been reviewed by the Maternal Mortality Committee of the California Medical Association and the Bureau of Maternal and Child Welfare of the State of California. In 56 of these deaths the underlying causes were due to disorders of placental separation and placental bed hemostasis. Each of these 56 cases has been analyzed. Profiles of characteristics of patients dying from placenta previa, placenta abruptio, and uterine atony are given. The expected causes of death due to delay in giving adequate amounts of blood and fibrinogen occurred in this series but the most striking results of this study were the findings of (1) a large number of cases of placenta acreta in patients with repeat cesarean sections and (2) the lack of manual exploration of the uterus in many patients dying from uterine atony.