London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1907

[Report of the Medical Officer of Health for London County Council]

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89
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 (a) the rise of temperature was noted(b) medical aid was called (c) the case was notified as puerperal fever and (d) in fatal cases when death occurred.

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 Cases1751261631--42
Fatal Cases-343321-11119
Medical help called
Recovery cases566710346111160
Fatal Cases6332421111226
Notification as puer -peral fever
Recovery cases-293565452160
Fatal cases-24114214726
When death occurred in fatal cases-112-221826

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-34346461810166
Fatal cases112951312712152

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.
Primipara20128
2 Para853
3 „1064
4 „55-
5„752
6 „33-
7 „321
8 „11-
9 „11-
10 or more321
Multipara (no definite statement)532
No statement20155
Total866026

The following conditions were noted with regard to 32 of these 86 cases:—

Recovery cases.Fatal cases.Total.
Adherent or retained placenta549
Torn perineum415
Ante partum hæmorrhage112
Prolonged labour and forceps cases628
Miscarriage or abortion112
Placenta prævia213
Uterus not contracting213