Annual report : 1934 / Society of the Lying-in Hospital of the City of New York.
- Society for the Lying-In Hospital
- Date:
- 1934
Licence: Public Domain Mark
Credit: Annual report : 1934 / Society of the Lying-in Hospital of the City of New York. Source: Wellcome Collection.
42/60 page 38
![delivered. The first two postpartum days were normal. On the third day patient had slight hemoptysis, chill, and temperature rose to 39.2° C., the pulse being 146. There was abdominal distention, and tenderness over the entire right abdomen. A diagnosis of pyelitis was made. On the fourth day the right kidney was catheterized. On the fifth day the impression was pelvic peritonitis. Blood chemistry showed non protein nitrogen 73.2 mg. Insulin was administered. There seemed to be some improve¬ ment in her condition until the twelfth day, when severe generalized ab¬ dominal pain occurred. Her condition grew steadily worse and the patient died on the fifteenth postpartum day. Autopsy: Generalized fibrino-purulent peritonitis, bilateral pyelitis. History No. 55678—Post Partum Hemorrhage Following Caesarean Section Mother, age 40, colored, para 2-0-1-1, Wassermann negative, pelvis normal. First delivery in 1920 mid-forceps; second pregnancy in 1921 terminated by caesarean section, indication unknown. Spontaneous abor¬ tion in 1927. Patient had had diabetes for past 3 years; treated for 18 months, by diet only. Blood sugar 153 mg. Patient admitted at onset of labor, and because of a large baby and patient’s past history and blood sugar of 96 mg. before meal and 140 mg. after meal, it was decided to perform a Caesarean section. Classical Caesarean section done under ether-gas anesthesia. Infant weighed 4850 gm.; was in good condition; discharged well. During the operation there was moderate bleeding, 500 cc. of blood estimated, and patient seemed in good condition, but the blood pressure was 80/50. Following operation, patient was given 500 cc. of 10% glucose intravenously with 25 units of insulin. Blood pressure remained 80/40. Patient lost 300 cc. more blood, uterus became soft, and patient went into shock. A short time later 300 cc. of blood were expressed. She was given 500 cc. of saline intravenously, pituitrin, gynergin, and tamponade of the uterus was done. Patient reacted well, was given 300 cc. of gum acacia; blood pressure 60/20. Suddenly 4-42/60 hours after operation the blood pressure fell to zero, and patient died without responding to any stimulation. Impression: Death due to post¬ partum hemorrhage. Blood loss estimated at between 1800 and 2000 cc. Autopsy: Thrombosis of ovarian veins Edema of uterus Congestion and edema of lungs Calcified nodules, subpleural, of right lung and tracheobronchial lymph nodes Fibrous pleural adhesions [38]](https://iiif.wellcomecollection.org/image/b31710979_0042.jp2/full/800%2C/0/default.jpg)
