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49
During the year there were 513 still-births reported by midwives in their practice.
The figures for previous years were : 1921, 684; 1922, 720; 1923, 582; 1924, 594;
1925, 510. Of these infants 272 were males and 235 females, and 6 not stated.
Of the 513 still-births, 272 were reported macerated, 227 not macerated, and in 14
cases the condition was not stated.
Still-births.
it, may De noted that section 7 of the Births and Deths Regisiranon act,
1926, which will come into force on the 1st July, 1927, requires that the birth of every
still-born child shall be registered by the registrar in a register of still-births containing
the heads of information prescribed in the First Schedule of the Act.
337 cases of puerperal fever were reported during the year, as against 316 the
previous year. 90 cases proved fatal, as compared with 78 the previous year, a case
mortality of over 26 per cent, as against over 23 per cent, the previous year. In
addition the Registrar-General recorded 30 deaths from puerperal sepsis, which
were, however, not notified as puerperal fever. The distribution of the notified
cases was as follows •—
Puerperal
fever.
Delivery conducted by Cases. Deaths.
(а) Medical practitioners 127 33
(б) Certified midwives 81 14
(c) Medical practitioner and certified midwife 8 2
(d) Hospitals and poor-law institutions 81 30
(e) Medical students 10 2
(/) Cases of miscarriage or abortion where no attendant was engaged 26 8
(g) Uncertified women 3 -
(h) No information 1 1
Total 337 90
Regulations were made by the Minister of Health during 192b making Puerperal
Pyrexia a notifiable disease. The Order which came into force 1st October, 1926,
defines the disease as" any febrile condition (other than a condition which is required
to be notified as Puerperal Fever under the Infectious Disease (Notification)
Acts) occurring in a woman within 21 days after childbirth or miscarriage in which
a temperature of 100-4 deg. Fahrenheit (38 deg. Centigrade) or more, has been sustained
during a period of 24 hours or has recurred during that period."
Puerperal Fever has been notifiable throughout the country since the Infectious
Disease (Notification) Extension Act 1899, but notification of the disease has been
far from complete, with the result that statistics are inaccurate and misleading and
measures for the prevention and effective treatment of the condition have been
seriously hampered. The main reason for the comparative failure to notify is that
Puerperal Fever is ill-defined and not a specific disease comparable with Scarlet
Fever or Diphtheria. The Medical Officer of a Local Sanitary Authority is required
to send a copy of every notification received from a medical practitioner to the
County Medical Officer within 24 hours of its receipt.
In London the Borough Medical Officers are also required to send a copy to the
Metropolitan Asylums Board within 12 hours. The number of notifications will it
is anticipated be numerous, but the great importance of securing adequate treatment
in the early Stages of puerperal infection is regarded as outweighing any objection to
the notification of a certain amount of minor illness which gives no cause for anxiety.
308 notifications of puerperal pyrexia were received, 12 of which proved fatal;
the distribution is as under :—
Delivery conducted by Cases. Deaths.
(а) Medical practitioners ... ... ... ... ... ... ... 83 7
(б) Certified midwives ... ... ... ... ... ... ... ... 58 2
(c) Medical practitioner and certified midwife ... ... ... ... 5 1
(d) Hospitals and poor-law institutions ... ... ... ... ... 137 —
(f) Medical students ... ... ... ... ... ... ... ... 5 —
(/) Cases of miscarriage or abortion where no attendant was engaged ... 20 2
308 12
Puerperal
pyrexia.