TUBERCULOSIS, CAUSE OF THE GREATEST NUMBER OF DEATHS OF WOMEN DURING THE CHILD-BEARING PERIOD
OBSTETRICS. A Text Book for the Use of Students and Practitioners. J. Whitridge Williams, Professor of Obstetrics, John Hopkins University, Obstetrician-in-Chief to the John Hopkins Hospital, Gynaecologist to the Union Protestant Infirmary, Baltimore, Md. D. Appleton & Co. 1912.
As a rule, all diseases which subject the organism to a considerable strain are much more serious when occurring in the pregnant woman. In general it may be said that pregnancy exerts a deleterious influence upon all chronic organic maladies, while its effect is usually less marked in acute infectious processes. The latter, however, frequently lead to premature delivery and the additional physical strain attending the latter matter render the course of the disease much less favorable. Page 489.
“Owing to the well known fact that pulmonary tuberculosis usually progresses much more rapidly after child bearing, it is advisable that tubercular women take every precaution to avoid the possibility of conception.” Page 383.
It would appear therefore that in the vast majority of cases the disease (tuberculosis) is not transmitted directly from the mother to the fetus, and that the latter is born with a tendency to tuberculosis, rather than with the disease itself. Hence it follows that the children of tubercular mothers should be brought under the best hygienic surroundings, and should not be suckled by their mothers. In view of the fact that the tubercular process usually becomes exacerbated either during pregnancy or after child birth, most authorities recommend that abortion be induced as a matter of routine in all tubercular women, and many that they be rendered sterile by artificial means. This appears to be a somewhat too extreme point of view, but I consider that abortion should be induced in the first pregnancy occurring after the onset of the disease, and whenever it makes its appearance during the early months of pregnancy. Page 494.
THE PRACTICE OF OBSTETRICS. In original contributions by American Authors. Edited by Reuben Peterson, A.B., M.D., Professor of Obstetrics and Gynaecology in the University of Michigan, Ann Arbor, Mich. Obstetrician-in-Chief to the University of Michigan Hospital. Lea Bros. & Co. Philadelphia and New York. 1907. Chapter IX.