Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London County Council]
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sequently, medical help was not advised by the midwife. A rise of temperature above 100*4° was
noted by the midwife in 61 cases out of the 77 cases delivered by midwives during the course of the
patient's illness and in 39 instances it was this symptom which led the midwife to seek medical help.
The following table shows with regard to 77 cases delivered by midwives and 9 where a medical practitioner was called for the actual delivery, the day of the puerperium when
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 | 1 | 7 | 5 | 12 | 6 | 1 | 6 | 3 | 1 | - | - | 42 |
Fatal Cases | - | 3 | 4 | 3 | 3 | 2 | 1 | - | 1 | 1 | 1 | 19 |
Medical help called | ||||||||||||
Recovery cases | 5 | 6 | 6 | 7 | 10 | 3 | 4 | 6 | 1 | 1 | 11 | 60 |
Fatal Cases | 6 | 3 | 3 | 2 | 4 | 2 | 1 | 1 | 1 | 1 | 2 | 26 |
Notification as puer -peral fever | ||||||||||||
Recovery cases | — | - | 2 | 9 | 3 | 5 | 6 | 5 | 4 | 5 | 21 | 60 |
Fatal cases | — | - | 2 | 4 | 1 | 1 | 4 | 2 | 1 | 4 | 7 | 26 |
When death occurred in fatal cases | — | - | — | — | 1 | 1 | 2 | - | 2 | 2 | 18 | 26 |
Of the 18 fatal cases where death occurred after the 10th day, 8 died within a fortnight of confinement,
6 within 2 to 3 weeks, 2 more under 4 weeks, 1 more within 5 weeks, and 1 lived for 4½
months after confinement.
The age incidence of the cases of puerperal fever was as follows:—
Under 15. | 15-20. | 20-25. | 25-30. | 30-35. | 35-40. | Over 40. | All ages. | |
---|---|---|---|---|---|---|---|---|
Recovery cases | - | 3 | 43 | 46 | 46 | 18 | 10 | 166 |
Fatal cases | 1 | 1 | 29 | 51 | 31 | 27 | 12 | 152 |
The parity where ascertained of women suffering from puerperal fever and attended by a midwife is shown in the following table:—
No. of cases. | Recovery. | Death. | |
---|---|---|---|
Primipara | 20 | 12 | 8 |
2 Para | 8 | 5 | 3 |
3 „ | 10 | 6 | 4 |
4 „ | 5 | 5 | - |
5„ | 7 | 5 | 2 |
6 „ | 3 | 3 | - |
7 „ | 3 | 2 | 1 |
8 „ | 1 | 1 | - |
9 „ | 1 | 1 | - |
10 or more | 3 | 2 | 1 |
Multipara (no definite statement) | 5 | 3 | 2 |
No statement | 20 | 15 | 5 |
Total | 86 | 60 | 26 |
The following conditions were noted with regard to 32 of these 86 cases:—
Recovery cases. | Fatal cases. | Total. | |
---|---|---|---|
Adherent or retained placenta | 5 | 4 | 9 |
Torn perineum | 4 | 1 | 5 |
Ante partum hæmorrhage | 1 | 1 | 2 |
Prolonged labour and forceps cases | 6 | 2 | 8 |
Miscarriage or abortion | 1 | 1 | 2 |
Placenta prævia | 2 | 1 | 3 |
Uterus not contracting | 2 | 1 | 3 |