Dr. D. B. Hart (E. M. J., Feb. 1888,) reports eight cases of this
complication with seven deaths. With reference to the etiology Dr. Hart
thinks the progress of the cardiac lesion is greatly accelerated by the
increased amount of work imposed upon the crippled heart during
pregnancy. At the beginning of labor, therefore, we may get failure of
compensation, dilated heart and engorgement of the lungs. At the close
of the labor, if free hæmorrhage does not occur, the extra blood before
accommodated in the utero-placental sinuses is returned to the right
heart. Death is therefore liable to occur in the third stage from over
distention of the right heart.
Dr. Ballantyne (E. M. J., March, 1888,) adds two more cases to the above
record, both terminating fatally. Sphygmograms obtained in these cases
show that the period immediately following the expulsion of the placenta
is the one of greatest danger, and they are entirely consistent with
Hart’s theory of the cause of death.