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temperature of 102.2 deg. immediately after labour, and it fluctuated
between 98.4 deg. and 102 deg. for the first four days. The
condition was diagnosed as pyelitis. On the eleventh day the
woman took lysol and was removed to hospital. She subsequently
recovered.
Eight of the 14 cases of puerperal pyrexia were confined in
hospital. Five were attended by midwives, and one by a doctor
assisted by a midwife.
Four of the six domiciliary cases were transferred to hospital
for treatment. The advice of the obstetric consultant was sought
in three of the six cases.
Obstetric Consultant.
The advice of the Council's Consultant Obstetrician was sought
on eight occasions during the year.
1. Case described under Puerperal Fever, No. 1 (40 weeks
pregnancy).
2. Case described under Puerperal Pyrexia (Septicaemia).
3. Primigravidae, aged 24—home circumstances good—normal
labour, attended by midwife—afebrile until seventh day when
temp. 103 deg. P. 108—rigor—nipples painful—temp, and pulse
remained high—seen by Consultant on ninth day—no urinary
symptoms—lochia normal—uterus well involuted—no clinical
evidence of puerperal sepsis. Diagnosis—diffuse parenchymatous
mastitis. Removed to hospital for treatment. Good recovery.
4. Multiparae (2), age 30. Home circumstances fair. Normal
labour of four hours—no laceration—haemorrhage not excessive—
attended by midwife—afebrile until sixth day when temperature
rose to 102.4 deg. P. 120—intermittent pyrexia continued until
ninth day with slight cough and intermittent pain low down in
right iliac fossa—seen by Consultant. Temp. 99.8 deg.—-P. 80—
general appearance fairly good—clean, moist tongue—no abnormal
physical signs in chest—no abnormal congestion of breasts—no
abnormal physical signs in abdomen beyond slight deep tenderness
in right iliac fossa—uterus well involuted—no abnormal tenderness
or swelling in pelvis—provisionally diagnosed as puerperal sepsis