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London County Council 1934

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

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Table: Analysis of deaths in 165 cases of puerperal sepsis. (14 deaths = 8.5 per cent.)

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Analysis of deaths in 165 cases of puerperal sepsis. (14 deaths = 8.5 per cent.)

No. of case.	Age.	Para.	Previous history.	Delivery.	Vaginal examination.	Diagnosis on admission.	Complications.	Course of disease.	Bacteriology.		Post-mortem findings.
22	32	IV Term	Poor health and vaginal discharge during pregnancy	Normal 6 hours labour.	+	Septic endo- and para-metritis.	General peritonitis onset 7th day.	Onset of pyrexia 3rd day post partum.	Cervical culture and peritoneal exudate hæm. metritis.		General peritonitis with pus in pelvis and in broad ligaments septic metritis
198	29	II Term	Normal pregnancy	Normal 5 hours labour.	+	Scarlet fever. Local uterine sepsis.	Septic arthritis shoulder 7th day. Generalised oedema ? serum reaction.	Onset of scarlet fever 3rd day post partum Admitted 5th day. Death 11th day.	Cervical culture hæm. strep.		Endometritis, septic spleen, oedema of lungs, kidney, brain.
147	23	II Term	Normal pregnancy	Normal 7 hours labour.	+	Septicaemia	General peritonitis onset 14th day.	Onset of pyrexia 4th day post partum. Admitted 10th day. Laparotomy 14th day. Death 20th day.	Cervical and peritoneal culture hæm. strep. Blood culture staph. albus.		No. P.M.
728	32	II Term	Normal pregnancy	Normal 5 hours labour.	+	Septic endometritis. Clinical septicaemia.	Generalised arthritis 6th day.	Onset of pyrexia 2nd day post partum. Admitted 5th day. Death 10th day.	Cervical culture hæm. strep. Blood culture sterile.		No P.M.
992	28	IV Term	Poor health during pregnancy.	Normal 6 hours labour. Portion of placenta retained.	None	Septic endometritis. Lobar pneumonia.	-	Onset of pyrexia 4th day post partum. Admitted 5th day. Death 6th day.	Cervix sterile		Left lower lobe, grey hepatization. Uterus bulky, septic endometritis, adherent fragment of placenta.
1753	26	I Term	Normal pregnancy	Normal 8 hours labour.	None	Scarlet fever. Local uterine sepsis.	Pleural effusion bilateral empyema onset 30th day ? peritonitis.	Onset of scarlet fever 4th day post partum. Onset pyrexia 10th day. Admitted 12th day. Death 60th day. Rib re-section 60th day.	Cervix (hæm.). Throat (strep.). Blood culture sterile.		Extensive bilateral empyema. Anterior mediastinitis. Extensive recent omental adhesions, pockets of pus in lower abdomen.
1517	31	III	Abortion at 6 weeks (spontaneous)		+	General peritonitis.	Pyelitis	Onset of pyrexia 5th day post partum. Admitted, and 1st laparotomy 8th day. 2nd laparotomy 42nd day, death 43rd day.	Cervix (B. coli). Urine (B. coli.). Peritoneal fluid (B. coli.).		General peritonitis, pelvis full of pus tracking up to liver. Tubes normal, uterus fibrotic, no evidence of injury. Liver and spleen septic. Acute haemorrhagic pyelonephritis.
1897	21	II Term	Always delicate. Normal pregnancy.	Normal B.B.A.— P.P.H. 11 hours labour.	None	Septicæmia anaemia.	-	Onset of pyrexia 4th day post partum. Admitted 5th day. Death 17th day.	Cervix	Hæm.	None.
1897	21	II Term	Always delicate. Normal pregnancy.	Normal B.B.A.— P.P.H. 11 hours labour.	None	Septicæmia anaemia.	-		Blood	strep.	None.