English Translation

Husslein, On the question of house or institutional birth 14 women have been lost to sepsis, of which 4 were external births. If these 4 cases are calculated, an overall mortality of 0.97o/oo remains; of this 3 deaths are attributable to spontaneous births in case of early arrival. Case 6 weeks before birth an abscess of Bartholini's gland was opened; in the second case there was pleuritis at the end of the pregnancy, from which there was a peritonitis; the third case we also lost to peritonitis; no autopsy was performed here. So this results in a mortality of 0.3o/oo for spontaneous births. 7 Deaths are attributable to surgical birth terminations with an overall mortality of 6.8o/oo. If one calculates the 3 deaths in which the birth started at home, then a mortality of 3.6o/o- Our actual institutional mortality of sepsis in spontaneous and surgically terminated births remains therefore 0.7o/OO. This result is particularly favourable compared to other publications and is a proof of our successful therapy, as it has been handled for years in the clinic (Knaus, Switzerland. med. Wschr. 1936, No. 46). Table III: Total number of primary secondary external births of female workers Institutional births Institution births 10512 9954 288 270 Deaths Deaths Mortality Deaths 14 7 3 4 Mortality 1.3%/00 Mortality 0.70/00 Mortality 10.5%/00 Morbidity 21o Morbidness 38o Spontaneous birth 0.3o 00 Surgical birth. 3,6o 00 Morbidity 1,50 We lost 7 women on incisions, whereby again 3 cases are called secondary institutional births (1 in the case of narrow pelvis, long after the bladder leap, 2 in Placenta praevia centralis, Exitus in both cases due to circulatory collapse). Our caesarean sectional frequency during this period is only 1.4%, contrary to other large statistics (price-secker, Kessler), which indicate an average of 3%. We have our own mortality of 4.3%. The other cases we have lost: 1 case of acute heart failure, pneumonia in the postpartum, interruptio in the 6th lunar month of Phthisis pulm. cavern., uterus rupture (Placenta increta; published Dworzak, Zbl. Gynäk. 1936, No. 2), 2 cases at Atonia uteri, Placenta increata, Ruptura aneurysm. art. lienalis (introduced after confinement moribund, 10 minutes later Exitus). Thus, the causes of death can be distinguished in three major groups. Death by Puerperalsepsis, to which I also count the cases of peritonitis; death by other consequences of pregnancy and birth and death due to other causes beyond pregnancy and childbirth. They are distributed as follows over the individual years (see Table IV): Of the 14 cases lost in Puerperalsepsis, the 4 cases of external births must be deducted, i.e. remain 10, which corresponds to a mortality of 0.97o/00. 1957