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116
Maternal Mortality.
There were seven maternal deaths in Leyton during the year.
Of these, four were due to sepsis, three following full time normal
deliveries and the fourth following presumed natural abortion.
Of the non-sepsis deaths, one was due to eclampsia ; one to retained
placenta (without haemorrhage) ; and the third to ruptured
ectopic gestation.
The details of the deaths due to sepsis were as follows
1. Multipara (3), age 31—circumstances poor—ante-natal
examination at hospital—normal labour (4| hours) in hospital—no
internal examination no laceration of perineum—temperature
99 (legs, on first day after labour—temperature 102 degs. and rigor
on fifth clay—cervical swab 10 days after labour showed haemolvtie
streptococci in large numbers—blood contained haemolvtie streptococci.
Died on twenty-third day following delivery. Post-mortem
examination threw no light on mode of infection and showed no
pre-existing disease.
2. One previous miscarriage. Age 29—ante-natal examinations
at hospital—no signs of toxaemia or pre-existing disease
except for slight discoloured vaginal discharge—normal labour
(12J hours)—3 vaginal examinations—masks, gloves and gowns
worn—no perineal laceration—afebrile until third day after labour
—rigor, temperature 102 clegs.—patient very nervous and excited—
intra-uterine glycerine given next day as uterus tender—generalised
abdominal tenderness with diarrhoea sixth day after labour—transferred
to Queen Charlotte's Hospital Isolation Block for
operation—saparotomv and drainage of peritoneal cavity—died 12
hours later. Post-mortem examination showed generalised peritonitis—bilateral
ovarian abscesses—thrombosed left ovarian vein—■
hemolytic streptococci from cervix, blood and peritoneal fluid.
3. Already dealt with as Case No. 5 under Puerperal Fever
cases above.
4. Following abortion—described under Puerperal Fever
cases above.
The details of the non-sepsis deaths were as follows :—
5. Age 31. Circumstances comfortable—ante-natal examinations
by private doctor—labour prolonged—slow and weak contractions—spontaneous
delivery (at 4 p.m.) of stillborn macerated