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139
Report by Dr. Hilda Menzies.
It is noteworthy that the two fatal cases were due to infection
following abortion. The information concerning them is scanty.
In both cases delay in obtaining treatment was due to the woman
failing to send for a doctor ; the doctors in each case transferred
the patient to hospital without further delay. The first was a
woman of 35 years with two children, circumstances fairly good.
She consulted the doctor at his surgery on account of pain following
a three months' abortion six days previously. The doctor suspected
interference and transferred her to hospital where she died eleven
days later from typical septicaemia.
The second fatal case was in a woman of 29 years, who had
had two living children and one previous miscarriage—home
circumstances poor. She had lost a considerable amount of blood
before sending for the doctor in the evening—at the shortest
estimate she had been losing for 15 hours. According to the
hospital report she had been losing for 30 hours. The explanation
of the delay in sending for the doctor was that the patient was
alone in the house until the husband came home. The patient
was in bed when the doctor arrived, not losing much blood and the
pulse was good. An examination was made with a sterile glove.
The os was patent, nothing else abnormal, but the patient complained
of much pain. The placenta had been expelled (? 12
weeks pregnancy) but the foetus was not found. The patient
was transferred to hospital as a case of incomplete abortion. On
admission the temperature was 101.2 degrees, pulse 108, uterus
somewhat enlarged but apparently empty. The temperature
remained irregular. Swellings developed on hands and legs.
The patient was treated with douches, prontosil, etc., but died
nine days later from puerperal pyaemia.
These two deaths are calculated as maternal deaths and are
included in the maternal mortality rate which is based on the
number of births in the Borough of Leyton, whereas they are
actually two deaths occurring out of an unknown number of
abortions having no ascertainable relation to the number of births.
They are deaths over which the present Maternity and Child
Welfare Scheme has no direct control.
Out of the ten cases of puerperal pyrexia following the birth
of a child, the baby survived in nine cases. The tenth was a case