London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1934
[Report of the Medical Officer of Health for London County Council]
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Analysis of cases of septicaemia (10). (First 2 cases included under" other diseases.")
| Para. Delivery. | Vag-inal exam. | Cervical swab. | Blood culture. | Clinical features. | Result. | |
|---|---|---|---|---|---|---|
| Multipara | Normal | Made | Sterile | Strep, viridans | No uterine sepsis. Infective endocarditis, cerebral embolism and hemiplegia. History of heart trouble during pregnancy. | Death. |
| Multipara | Normal 7 mos. (S.B.) | Made | Not taken | Haem. strep. | Influenzal pneumonia onset 3 days before delivery. No uterine sepsis. | Death. |
| Multipara | Normal | Made | Hsem. strep. | Staph, albus. | Laparotomy, general peritonitis, haem. strep, in pus. | Death. |
| Multipara | Normal | Made | Haem. strep. | Sterile | Clinical septicaemia. Septic endometritis and general septic arthritis. | Death. |
| Multipara | Normal. | Made | Hsem. strep. | Haem. strep. | Local uterine sepsis, severe anaemia. | Death. |
| Multipara | Normal | Made | Hsem. strep. | Haem. strep. | Septic thrombosis pelvic veins. Pelvic peritonitis, pericarditis (P.M.). | Death. |
| Multipara | Normal | Made | Pneumo-coccus (same | Pneumo- coccus type) | Cellulitis elbow pus: pneumococcus. | Recovery. |
| Multipara | Abortion. Curetted before adm. | Non-hsem. strep, and B. coli. | Nonhaemstrep. | Laparotomy, general peritonitis and pelvic abscess. | Death. | |
| Multipara | Instrumental. | Made | B. coli | B. coli... | Septic endometritis. Pyelitis. Enterocolitis. | Death. |
| Primipara | Instrumental. | Made | Haem. strep. | Hsem. strep. | Pelvic abscess, vaginal and perineal sepsis. Pelvic peritonitis. Laparotomy. Hsem. strep, exudate from wound. | Recovery. |
9. Cases not included in above classification.—There were 4 cases showing local
uterine sepsis plus other complications:—
(i) Scarlet fever and septic arthritis of shoulder (multipara, normal delivery,
hsom. strep, in cervix). Fatal.
(ii) Septic endometritis and lobar pneumonia. Fatal. (Multipara, normal
delivery, ccrvix sterile).
(iii) Fibroid uterus with septic thrombosis of pelvic veins with septic infarct
of lung and empyema. Fatal. (Multipara twins still-born 8 months.
Cervix staph, albus.).
(iv) Thrombosis of pelvic veins and cerebral embolus. (Multipara,, normal
delivery, cervix sterile). Recovered.
Femoral thrombosis.—11 cases.
(a) Multipara, 7. Normal delivery 6
Abortion 1
(b) Primipara, 4. Normal delivery 2
Instrumental delivery 2
Thrombosis occurred in left leg only in 7 cases, and was bilateral in 4.
Cervical swab : Hemolytic streptococci in 6 cases.
Streptococcus viridans 1 ,,
B. coli „ 2 „
Staphylococcus „ 2 „ (both instrumental).
Local uterine sepsis was present in all cases and only two presented other
complications: one case of pelvic peritonitis with pelvic and bilateral femoral
venous thrombosis. The other, a case of h Hemolytic streptococci general peritonitis
with thrombosis of the left saphenous vein, was the only fatal case in this series.