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milk. On the fourth day the patient had a rigor and was admitted
to the Isolation Hospital. The haemolytic streptococcus was
grown from the cervix, and she died on the 12th day from peritonitis
and septicaemia.
Of the patients who died of some condition other than sepsis
one was due to obstructed labour in whom there had been no
ante-natal supervision. Another similar case who had received
full ante-natal supervision failed to deliver herself until a
craniotomy was performed. One of the fatal cases was due to
toxaemia of pregnancy, the patient developing acute yellow
atrophy of the liver. The death of one patient occurred through
labour overtaxing a damaged heart.
It is interesting to note that not one of these patients had
attended the local ante-natal clinics.
Puerperal Fever and Pyrexia.
12 notifications were received during the year, 10 being
puerperal pyrexia and two puerperal fever. Per 1,000 total
births (i.e., live and stillbirths) the rates for these conditions
were 5.4 and 1.1, the corresponding figures for the country as
a whole being 9.6 and 3.5.
One case proved fatal, the patient having, after a normal
labour which resulted in a slight tear, a rigor on the 5th day.
One case developed scarlet fever on the 4th day from the confinement.
In two cases the raised temperature was ascribed to a
chill, one following an uncomplicated labour in a primigravida,
the temperature being raised on the fourth day ; the other who had
a B.B.A. delivery having a one-day rise of temperature on the
third day. Two other primigravidae who had straightforward
confinements, but who had slight tears, had raised temperatures
on the 3rd and 4th days, but made uninterrupted recoveries.
A rise of temperature which occurred in one patient on the 9th
day was apparently due to a slight mastitis. Another primigravida
whose temperature was raised on the 3rd day after a normal
confinement, had shortly before suffered from pleurisy and
influenza, and subsequently developed pneumonia. It will be
noted that five of these cases were primigravidae who had norma
labours.
The other four cases were complicated labours, three of the®
being breech deliveries, one complicated by placenta praevis
and another by a perineal tear. The other case was one who developed
a post-partum haemorrhage due to an adherent placenta.