London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1908
[Report of the Medical Officer of Health for London County Council]
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91
With regard to the 51 cases delivered by certified midwives, medical help was summoned in 38
instances on account of rise of temperature, either alone or in conjunction with other symptoms. In
8 instances the midwives state that no symptoms of puerperal fever were observed during the 10 days
they attended on the patient, and in these cases medical help was summoned by the patient's friends on
the 11th, 12th, 13th, 14th (twice), 15th, 18th and 20th days.
The following table shows the day of the puerperium on which (a) the rise of temperature was first noted by the midwife
| Day of Confinement. | 2nd day. | 3rd day. | 4th day. | 5th day. | 6th day. | 7th day. | 8th day. | 9th day. | 10th day. | After 10th day. | Total. | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rise of temperature Recovery cases | – | 3 | 3 | 7 | 4 | 2 | – | 3 | 2 | 4 | – | 28 |
| Fatal cases | 1 | — | — | 4 | 1 | 2 | — | – | 2 | – | – | 10 |
| Medical Practioner called Recovery cases | – | 3 | 3 | 7 | 4 | 3 | – | 2 | 2 | 4 | 8 | 36 |
| Fatal cases | 1 | 3 | — | 2 | 3 | 2 | – | – | 2 | – | 2 | 15 |
| Notified as puerperal fever Recovery cases | – | – | – | 4 | – | 2 | 5 | 2 | 2 | 4 | 17 | 36 |
| Fatal cases | – | 1 | 2 | – | – | – | 1 | 3 | 1 | – | 5 | 13* |
| When death occurred in the fatal cases | – | 2 | – | – | – | 1 | – | – | 1 | 2 | 9 | 15 |
Of the 9 cases where the patient died after the 10th day of the puerperium, two died on the 12th day, one each on the 14th, 16th, 18th, 19th, 22nd, 28th and 35th days.
The age incidence of the cases of puerperal fever was as follows:—
| Total. | Age. | |||||||
|---|---|---|---|---|---|---|---|---|
| 15-20. | 20-25. | 25-30. | 30-35. | 35-40. | 40-45. | 45 and up. | ||
| Recovery cases | 141 | 4 | 43 | 33 | 29 | 23 | 8 | 1 |
| Fatal cases | 137 | 3 | 22 | 37 | 37 | 27 | 11 | – |
The parity of women suffering from puerperal fever was ascertained as far as possible in the 51 cases attended by certified midwives and is shown in the following table.
| No. of cases. | Recovered. | Died. | |
|---|---|---|---|
| Primipara | 7 | 6 | 1 |
| 2 Para | 7 | 5 | 2 |
| 3 „ | 4 | 2 | 2 |
| 4 „ | 5 | 4 | 1 |
| 5 „ | 4 | 1 | 3 |
| 6 „ | 3 | 2 | 1 |
| 7 „ | 3 | 3 | – |
| 8 „ | 1 | 1 | – |
| 9 „ | 3 | 2 | 1 |
| 10 or more para | 5 | 4 | 1 |
| Multipara (no definite statement) | 5 | 3 | 2 |
| No statement | 4 | 3 | 1 |
| Total | 51 | 36 | 15 |
The following conditions were noted among the cases of puerperal fever delivered by certified midwives:—
| Laceration of the perineum | in 4 cases. |
| Adherent placenta | in 3 cases. |
| Retained pieces of placenta or membrane | in 8 cases. |
| Post partum hæmorrhage | in 2 cases. |
| Abdominal pain or tenderness | in 6 cases. |
| Excessive sickness | in 1 case. |
* Two fatal cases, one of septicaemia and one of pneumonia, were not notified as puerperal fever.