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hospital. One case failed to obtain ante-natal advice until too late,
and four cases were under the care of their own doctors for antenatal
supervision.
These deaths emphasise once more the importance of educating
women as to the necessity of obtaining medical care in cases of
abortion or miscarriage; and the necessity of pregnant women to
obtain ante-natal advice; but they do not suggest that the time
is yet ripe for abolishing the existing services.
There were three other deaths in which pregnancy or confinement
contributed in some degree to the fatal termination, though no
mention was made of the fact on the death certificate. A woman
started an attack of influenza on the 29th, commenced labour on
the 31st, had a retained placenta and died on the 2nd of the next
month of pneumonia. Another woman who had a rheumatic
heart was delivered on the 31st and died on the 4th of the next
month from "mitral stenosis and secondary anaemia." In the
third case death was possibly hastened; the woman was confined
on the 4th and died on the 8th of the month of "toxaemia, acute
intestinal obstruction, carcinoma of colon."
Puerperal Fever and Pyrexia.
18 notifications were received, 18 being of puerperal pyrexia
and 5 of puerperal fever. Per 1,000 total births (i.e., live and stillbirths),
the rates for these conditions were 6.6 and 2.5, the corresponding
figures for the country as a whole being 8.5 and 3.3.
Of the cases notified as puerperal pyrexia, three died, one from
puerperal septicaemia," another from " puerperal fever," and the
third from "pyelonephritis." Of the 10 remaining cases, six followed
an apparently normal confinement, one was a forceps delivery
and one was a case of pernea suture. Of these, two were admitted
to oldchurh Hospital and one to Rush Green. One case of puerpera
pyrexia was of a patient who had had a caesarean section
performed in hospital, and in another the raised temperature followed
on an incomplete abortion, the case having been admitted
to hospital.
Of the 5 cases notified as suffering from puerperal fever, two
died in both cases the sepsis having followed an abortion. In
two perineum sutured, the infant was delivered by the aid of forceps and
the perineum sutured. The other case notified as suffering from
puerperal fever was a woman who aborted and recovered after
hospital treatment, These five cases were all admitted to hospital,
three being to oldchurch, one to Rush Green and one to one of the