View report page

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 1952 was 35.38 per 1,000 total births, compared
with 17.04 in 1951, and 6.83 in 1950.
Puerperal
Pyrexia
This large increase in notifications since 1950 is misleading and is due to the
Puerperal Pyrexia 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 accidcnts (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
B