If the contractions have not begun, they should be stimulated by the introduction of a Vorhees bag, which, at the same time, dilates the canal and mechanically shuts off the bleeding vessels by compression. In introducing the bag, the membranes may be ruptured so the bag will pass into the uterine cavity. When the implantation is central, the finger must tear a hole through the placenta, and through this opening pass the bag inside the uterus. If the os is partially dilated, version may be done, and a foot brought down. The leg may then be pulled upon until it compresses the bleeding area and the traction maintained with a slowly developing pressure sufficient to check the hæmorrhage, until dilatation is advanced enough for delivery. Occasionally good results are obtained by tightly packing the cervix and vagina with gauze or cotton. (See Vaginal Tampon, p. 204.) Cæsarean section may be done in the interests of the child, as well as the mother. The fœtal mortality in placenta prævia is said to be 60 per cent and the maternal 10 per cent. _Differential diagnosis between_ _Accidental hæmorrhage_ _and_ _Placenta prævia_ Usually occurs in later months. Any time after the twenty-eighth week. May be concealed or open. Always open and external. Soon followed by labor pains. Labor need not occur. Uterus becomes larger if bleeding Uterus remains same size. is concealed. Uterus hard and woodeny. Uterus, normal consistency. In severe cases, signs of shock In severe cases, signs of shock whether hæmorrhage is external or follow the invariable external internal. hæmorrhage. No placenta can be felt. Placenta can be felt through the os. Hæmorrhage continues. Hæmorrhage intermittent. No history of previous attack. Possibly history of previous attack. No contractions after labor begins Contractions as usual. in serious cases. No bogginess of cervix. Cervix boggy. Hæmorrhages may occur _during labor_ from retention of the major part of the placenta while a portion is detached. This may be due to pre-existent disease, such as endometritis, or from uterine inertia. Normally the placenta will separate and be discharged within an hour after labor and in the absence of hæmorrhage it may go even longer than this with safety. The occurrence of severe hæmorrhage, however, requires the immediate cleaning out of the uterus by inserting the hand and peeling the placenta from its attachments. =Post partum hæmorrhage= includes all hæmorrhages that occur after the delivery of the placenta.