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Report of the County Medical Officer—General.
87
The medical evidence given at the inquests as to the cause of death was as follows:-
Mothers. Infants.
Rupture of uterus 1 Atelectasis 8
Peritonitis 1 Suffocation at birth 9
Heart disease 2 Suffocation in bed 19
Cerebral haemorrhage 1 Prematurity and debility 13
Collapse from long labour 1 Convulsions 11
Eclampsia 1 Bronchitis and pneumonia 4
Want of skilled attention at birth 4
Cerebral haemorrhage 4
Tetanus 1
Syncope 1
Marasmus 1
Congestion of stomach 1
Congenital heart disease or malformation 4
Stillbirth 6
7 86
During the year 1912, 380 cases of puerperal fever were notified in the County and
the Registrar General records 159 deaths from puerperal septic disease during the year. Three
deaths recorded by the Registrar General refer to cases which were notified in 1911. The term
puerperal septic disease used by the Registrar General includes puerperal septicaemia, pyaemia
and sapræmia, as well as peritonitis and metritis occurring in connection with parturition.
A list of deaths is received weekly from the Registrar General and the deaths are compared
with the notified cases so that it is possible to ascertain whether the latter terminate fatally. Of the 380
notified cases, 124 proved fatal, a case mortality of 32.7 per cent. Of the remaining deaths recorded,
one occurred in a London institution, the patient having been confined outside London and probably
notified as puerperal fever in the district where the confinement took place. The other deaths
related to cases which were not notified.

Puerperal
fever.
The following table gives the results of these
inquiries which relate to the 380 notified cases and 35 deaths of cases not notified in London:—
Delivery conducted by
Cases.
Deaths.
(a) Medical practitioners (including cases attended by medical students
and also cases in which a medical practitioner was in charge
of the case, but the birth took place before his arrival)
243
97
(b) Certified midwives (including cases in which birth took place before
the arrival of the midwife)
106
29
(c) Medical practitioner and certified midwife, i.e., cases in which a
midwife was unable to deliver and called in a medical practitioner
10
4
(d) Hospitals and poor law institutions
28
12
(e) Cases of miscarriage or abortion where no attendant was engaged
28
17
415
159