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The details available regarding these eight cases suggest (I)
that if a woman has a rise of temperature following abortion she
ought to be sent into hospital without delay ; (2) that a rise of
temperature following labour with no localising signs and no
(subjective) symptoms ought to be viewed even more gravely than
a case with signs of definite local infection. There is a tendency,
both on the part of midwives and of general medical practitioners,
to assume that a rise of temperature without symptoms is due to a
non-puerperal cause, and valuable time in instituting treatment
is lost.
Puerperal Pyrexia.
As a result of investigations regarding the 12 notified cases of
puerperal pyrexia, the causes of pyrexia were considered to be :—
Pyelitis 4
Mastitis 2
Endometritis 1
Mammary Abscess 1
Uterine sepsis followed by breast abscess 1
Pulmonary tuberculosis 1
Cause unknown 2
Eleven mothers recovered. There was one stillbirth and one
child died subsequently. This latter was a case where the mother
(age 27) was discovered during the puerperium to be suffering from
pulmonary tuberculosis and she died four months after the birth
of the child. She was attended by a midwife, and during the antenatal
period was noted to be pale and very thin. She refused to
attend an ante-natal clinic. Her husband was in regular employment
and the home conditions appeared to be satisfactory. This
was the second pregnancy and resulted in a premature child ; the
first child had lived for one hour. The patient developed a severe
cough on the second day after labour and her morning temperature
was 100.8 degs. The Council's Obstetric Consultant could find no
localising signs to account for the rise of temperature and pulse
rate, and advised her removal to hospital. She was subsequently
discovered to have a sputum containing tubercle bacilli.
The stillbirth was of a premature, slightly macerated foetus
in a woman aged 25, who had previously borne two living children.
The pyrexia was transient and the cause was not diagnosed.