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16
There were 16 deaths from sepsis, of which 13 were post-abortive and 3 followed
childbirth.
Puerperal fever is now no longer notifiable as such in the County of London as
the term is covered by puerperal pyrexia, thus bringing the county into line with the
rest of the country. The notification rate in 1951 was 17.04 per 1,000 total births,
compared with 6.83 in 1950.
This large increase in notifications since the previous year is misleading and is
due to the Puerperal Regulations of 1951 which now require the inclusion of cases
notified in the hospitals. Many of these relate to maternity patients residing outside
the County.
The trend of maternal mortality in the Administrative County of London from
1891 is shown in Table 3. It will be observed from this Table that maternal mortality
fell very slowly until the introduction of the sulphonamides in the middle '30s,
resulting in a substantial decline in the mortality from puerperal infection. In
recent years puerperal sepsis has lost its position as the most serious mortality risk
in pregnancy and has been displaced by toxaemia, haemorrhage and other accidents
(trauma of the pelvic organs, etc.), which now contribute the greater part of the
total mortality, though the risk of death from this cause has also been falling rapidly.
The effect of war conditions in arresting temporarily the decline in maternal
mortality in London is shown by the following diagram, which indicates the movement
of the rates in both London and over the country as a whole. The sharp rise
in London in 1941 was not shared by the country as a whole, and this can be attributed
to the effect of the air bombardment, which reached its peak intensity in that
year, and the subsequent evacuation. These factors rendered it difficult to maintain
the normal high standards of maternal care. Since the war further considerable
progress has been made.
MATERNAL MORTALITY ( EXCLUDING ABORTION)
MORTALITY PER 1,000 TOTAL BIRTHS
ENGLAND &. WALES LONDON
Infectious Diseases
The attack rates and death-rates of the principal infectious diseases in London
during 1951 and earlier years, and for the constituent metropolitan boroughs in 1951,
are shown in Tables 2, 3 and 9. In order to preserve uniformity with national statistics
the notification figures used in this section of the report have been corrected as far
as possible to take account of changes of diagnosis made after the original notifications
had been received. (See footnote to Table 9.)