[Report 1930] / Medical Officer of Health, Glasgow.

  • Glasgow (Scotland)
Date:
1930
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1930] / Medical Officer of Health, Glasgow. Source: Wellcome Collection.

    10/422 (page 10)
    reports and in the medical and lay press to maternal mortality and invalidity due to child birth. Enquiries under the aegis of the Depart- ment of Health for Scotland are being conducted with the help of medical practitioners throughout the City. Puerperal sepsis contri- butes largely to maternal sickness and death. In 1929 there came into force the Puerperal Fever and Pyrexia Regulations, which made the presence of even a mild degree of pyrexia or fever in women after child birth a notifiable condition by itself whatever its cause might be. The effect of these regulations in operation is fully discussed in the report, and it is obvious that a great improvement has taken place in reporting and securing appropriate treatment for this infection for which increased hospital provision has been made. It is difficult to assess correctly the mass of undefined pyrexias, and much con- sideration has been given to putting the question of classification on as sound a footing as possible in order to judge future incidence and results of treatment. A portion of the report is, therefore, devoted to a discussion of the facts as disclosed by the notifications of puerperal pyrexia and puerperal fever. Suitable ward accommodation (50 beds) under open air principles has been made available at Robroyston, where due regard can be paid to the isolation of virulent and highly infectious cases by the provision of cubicle observation wards. In view of the importance of the subject, there is incorporated in the report the results of an investigation into the epidemiology, bacteriology and treatment of puerperal sepsis by Dr. Margaret Thomas, carried out in Belvidere Fever Hospital. Among the 800 patients with whom her survey deals, no less than one-fourth were infections following abortions or miscarriages, a rather unexpected proportion. Dr. Thomas points out that the prevalence of this associa- tion is apt to be overlooked. In 43 per cent, of the total patients, the infection was of an extremely severe type: invasion of the blood stream was ascertained in 14 per cent. Milder cases lend themselves to appropriate treatment, but this high proportion of severe infections accounts for the case mortality rate of 15 per cent., which is a fairly low figure considering the gravity of this disease. Dr. Thomas reviews with great care the results of various methods of treatment advocated from time to time with regard to which certain distinct advances have been made in recent years. The problem of preventing puerperal sepsis is an extremely difficult one, into which many factors apparently enter. It may be remarked that the elimination of the very grave types of the disease, which form so high a proportion of the cases, will constitute a very severe test of the efficacy of whatever specific preventive measures may be adopted in actual practice.