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115
Five of the twelve eases of puerperal pyrexia were confined in
hospital. Six were attended by midwives (one in a maternity
home), and one was attended by a doctor assisted by a midwife, in a
maternity home. In one case it was considered advisable to transfer
the mother and babv to hsopital. The remainder were treated at
home.
Tlie advice of the Obstetric Consultant was sought in three
cases including the case of pulmonary tuberculosis.
Obstetric Consultant.
The advice of the Council's Consultant Obstetrician was sought
on five occasions during the year.
1. Case described under Puerperal Fever No. 1. (40 weeks
pregnancy).
2. Case described under Puerperal Fever No. 3. (40 weeks
pregnancy).
3. Case described under Puerperal Pyrexia (pulmonary
tuberculosis).
4. Primigravida. Home conditions poor—husband out of
work—normal labour, attended by midwife—mask worn—-temperature
102 degs., pulse 104 on second day following labour—seen
by consultant on third day—temperature 100.5 degs., pulse 110—
no abnormal physical signs—bacteriological investigation showed
presence of haemolytic streptococci—diagnosis, local puerperal
infection of uterus—temperature normal three days later. Hemolytic
streptococci were isolated from the midwife's throat and she wis
suspended temporarily from practice.
5. Primigravida, age 20—-confined in maternity home—
attended by doctor assisted by midwife—breech presentation—
perineal laceration—retention of urine—catheterised—pyrexia up
to 09 degs. for first 10 days—up to 100 degs. for next 3 days—severe
pyrexia more than puerperal morbidity for subsequent 3(5 hours—
seen by consultant. Nil abnormal in heart, throat, lungs or
abdomen. Uterus mobile and well involuted. Diagnosis, puerperal
pyelitis. Catheter specimen of urine grew B. Coli on culture and a
cervical swab grew hemolytic streptococci and B. Coli. Throat
swab from midwife grew hemolytic streptococci—patient made
complete recovery.