In support of this contention, Dr. Williams reports upon a series of 10,000 consecutive deliveries which took place under his observation, and in which syphilis caused 26.4 per cent. of the deaths among 705 babies who died after the seventh month of pregnancy or during the first two weeks after birth. Furthermore, nearly as many more babies who were discharged alive, at the age of two weeks, died in a short time or gave evidence of having syphilis later on in life.
Believing in the importance of diagnosing and treating this disease during pregnancy, Dr. Williams subsequently made observations upon 4,000 cases in which Wassermann tests were given, and to which 421 women gave positive reactions. In this series of 4,000 deliveries, 302 babies died during the last two months of uterine life, or the first two weeks of extra-uterine existence. The relative frequency of the various causes which worked destruction in these 302 little lives is given by Dr. Williams in the following table:—
| Syphilis | 104 | cases | 34.44% |
| Dystocia | 46 | cases | 15.20% |
| Toxemia | 35 | cases | 11.55% |
| Prematurity | 32 | cases | 10.59% |
| Cause unknown | 26 | cases | 8.61% |
| Placenta prævia and premature separation | 16 | cases | 5.28% |
| Deformity | 11 | cases | 3.64% |
| Eleven other causes | 32 | cases | 10.69% |
| Total | 302 | 100.00% |
It will be seen from these figures that syphilis caused almost as many deaths as the three causes, next in order, combined.
The effect upon the child’s chances for life, of treating the expectant mother for syphilis, is suggested by comparing the results among the 421 syphilitic women who were not treated at all; those treated insufficiently by receiving but two or three doses of salvarsan and no after-treatment of mercury (because of the patient’s lack of cooperation or because treatment was instituted too late in pregnancy); and those treated satisfactorily, which meant the administration of from four to six doses of salvarsan followed by mercurial treatment continued sufficiently long to result in a Wassermann reaction that was negative, and remained so.
Among those mothers who were not treated, 52 per cent. of the babies were born dead or had syphilis; among those treated incompletely, 37 per cent. and among those treated until cured, syphilis caused the death of or was demonstrable in but 6.7 per cent. of the babies.[[5]]
The deductions to be made from these dramatic figures is, that although syphilis seems to have about the same effect upon the pregnant, as the non-pregnant woman, it constitutes a serious menace to infant life and health.
Accordingly, it is very important that every pregnant woman be given the Wassermann test as early as the third or fourth month, and any woman who gives a positive reaction should be urged to submit to intensive treatment until cured. Her compliance will apparently multiply by seven or eight her expected baby’s chances for life.
Heart Lesions sometimes present grave complications during pregnancy, or at the time of labor, because the damaged or weakened heart is unable to meet the greatly added strain put upon it at these times. Spontaneous, premature labor sometimes results from serious heart trouble, while in some cases labor is artificially induced to relieve the overworked organ of the strain that is evidently exhausting it. Quite obviously it is an important step toward the prevention of both these deplorable occurrences to have the difficulty recognized early. Rest in bed and the same kind of medical treatment that would ordinarily be given for a poorly compensating heart will sometimes enable the disabled organ to carry its load throughout pregnancy. But care is necessary.
Pulmonary Tuberculosis is so common under all conditions that it is not surprising to find it fairly often among pregnant women. Since the treatment for this disease consists largely of effort to conserve the patient’s forces and build up the bodily resistance, the drain which pregnancy makes upon the system is likely to be inimical to the tuberculous patient’s improvement. It is the general opinion, therefore, that the tuberculous patient grows worse during pregnancy, and is still further weakened by the ordeal of labor and the drain of nursing her baby.