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from heart failure the next day; (2) the other patient who was
admitted to a nursing home on the 11th May had a normal labour,
being delivered on the 13th, but died on the 15th from diabetic
coma.
Pregnancy was the causative factor in the other cases:—
(1) after exhibiting no abnormal signs or symptoms during her
pregnancy this patient while giving birth to a full-time child at
her first pregnancy in a nursing home developed eclampsia to which
she succumbed; (2) this patient, a midwife's case, was referred
by the practitioner summoned on account of albuminuria, to
hospital when she was about 34 to 36 weeks pregnant. As she
failed to respond to treatment the membranes were ruptured and
soon after she developed a concealed retroplacental haemorrhage
which caused collapse. Spontaneous delivery of a stillbirth later
occurred but anuria developed and the patient died the next
day ; (3) the remaining fatal case was that of an evacuee from a
coast town who, during labour in a nursing home developed
uterine inertia. Delivery was followed by adherence of the
placenta which resulted in severe post-partum haemorrhage and
death. It was suggested that the atonic condition of the uterus
was associated with the air raid in progress during delivery.
PUERPERAL INFECTION.
Nine notifications of puerperal pyrexia were received, of
which two related to women who were in-patients at London
hospitals, and one to a patient who had been admitted to a hospital
outside the area because of an abortion. The raised temperature
in three of the remaining cases was probably due to infection of a
perineal suture and in one to a breast abscess. Of the remaining
two cases, one in which there was a normal delivery was considered
by the consultant to be a true puerperal infection; the other
case was one in which a forceps delivery was followed by retention
of the placenta, which because of haemorrhage needed manual
removal.
Four of the patients were admitted under the Council's arrangements
to hospital for treatment.