London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1906
[Report of the Medical Officer of Health for London County Council]
This page requires JavaScript
88
Of the 00 cases attended by certified midwives, each of 15 midwives had more than one case
during the year, viz.:—
Two midwives (A and B) had four cases each. (A) had two in January, one in April, one
in July. These cases followed a case in December, 1905. As the result of enquiry there seemed
to be no ground for attributing the septic infection to the midwife, and it was noted that three of
the patients resided in mews. (B) had two cases in February, one in May, one in November.
In the second of the cases in February the confinement took place before notification of the first
case as septic.
Three midwives (D, E, and F) had three cases each during the year.—(D) had two cases
in January, one in November. In the second of the cases in January confinement took place
before notification of the first case as septic. (E) had one case in February, two in August (one
of which was said to be a case of eclampsia). (F) had one in May, a second in June, and a third
in October. There was an interval of five weeks between the disinfection of the midwife after
attending the first and the confinement of the second case.
Ten midwives had two cases each during the year. The interval between the first and
second cases was less than eight weeks in only two instances, and in these the midwife had been
disinfected prior to delivering the second patient. There seems to be some doubt in both these
instances whether the second case was actually one of puerperal fever.
The following table shows the number of children previously borne by the puerperal fever patients :—
| Cases. | Deaths. | |
|---|---|---|
| Primipara | 18 | 7 |
| 2 para | 5 | — |
| 3 „ | 7 | 1 |
| 4 „ | 7 | 2 |
| 5 „ | 7 | 5 |
| 6 „ | 3 | 1 |
| 7 „ | 4 | 3 |
| 10 para | 1 | 1 |
| 11, 12 „ | 3 | — |
| Multipara (but number not given) | 10 | 5 |
| No statement | 25 | 13 |
| 90 | 38 |
In the 38 fatal cases of puerperal fever death was certified to be attributable to the following causes:—
| Septicæmia | 24 |
| Puerperal peritonitis | 5 |
| Pyæmia | 2 |
| Puerperal fever | 2 |
| Eclampsia | 2 |
| Acute blood poisoning | 1 |
| Septic Parotitis | 1 |
| Puerperal septic absorption | 1 |
| 38 |
Of 124 instances where medical aid was called in on account of a rise of temperature, 38 were subsequently notified as puerperal fever. In many cases medical aid had been called in for some other reason, and the following table shows that in 39 instances out of the 90 cases of puerperal fever which occurred in the practice of midwives the history of the puerperium showed the following abnormalities :—
| Condition. | Non.Futal. | Fatal. | Total. |
|---|---|---|---|
| Perineal rupture | 6 | 4 | 10 |
| Retained or adherent placenta | 5 | 4 | 9 |
| Ante partum hœmorrhage or previous illness of patient | 8 | 3 | 11 |
| Difficult labour, forceps used | 4 | 5 | 9 |
The following table shows, with regard to the 00 cases of puerperal fever occurring in the practice
of midwives the day on which (a) rise of temperature occurred, (b) a medical practitioner was called in,
(c) the case was notified :—