The treatment is to stop the gestation at a point before either mother or child, or both, are in danger either to life or to health. Page 1041.
MATERNAL MORTALITY. Grace L. Meigs, M.D., U. S. Department of Labor. 1917.
Puerperal albuminuria and convulsions, called also eclampsia, or toxemia of pregnancy, is a disease which occurs most frequently during pregnancy but may occur at or following confinement. It is a relatively frequent complication among women bearing their first children. When fully established its chief symptoms are convulsions and unconsciousness. In the early stages of the disease the symptoms are slight puffiness of the face, hands, and feet; headache; albumen in the urine; and usually a rise in blood pressure. Very often proper treatment and diet at the beginning of such early symptoms may prevent the development of the disease; but in many cases where the disease is well established before the physician is consulted, the woman and baby can not be saved by any treatment. In the prevention of deaths from this cause it is essential, therefore, that each woman, especially each woman bearing her first child, should know what she can do, by proper hygiene and diet, to prevent the disease; that she should know the meaning of these early symptoms if they arise, so that she may seek at once the advice of her doctor; and that she should have regular supervision during pregnancy, with examination of the urine at intervals.
DIABETES
THE PRINCIPLES AND PRACTICE OF OBSTETRICS. Joseph B. De Lee, M.D. Page 514.
Without doubt pregnancy has a bad effect on the course of this disease. It may develop a latent diabetes, there being cases where severe symptoms appeared only during successive pregnancies, and others where the disease grew progressively worse each time. Coma occurs in 30% of the cases and is almost always fatal. It may be brought on by a slight shock in pregnancy, but more often during and just after labor. Delivery seems to have a worse effect than most surgical operations, causing collapse, coma, or sudden death. Bronchitis has been noted in the puerperium, and this has been found to eventuate in tuberculosis. True diabetes has a very bad prognosis, authorities finding over 50% mortality, of which 30% died in coma, within two and one half years, and too often the child dies in utero.
PELVIC DEFORMITIES
MATERNAL MORTALITY. Grace L. Meigs, M.D., U. S. Department of Labor, 1917.
Some obstruction to labor in the small size or abnormal shape of the pelvic canal causes many deaths of mothers included in the class “other accidents of labor” and also many stillbirths. If such difficulty is discovered before labor, proper treatment will in almost all cases insure the life of mother and child; if it is not discovered until labor has begun, or perhaps until it has continued for many hours, the danger to both is greatly increased. Every woman, therefore, should have during pregnancy—and above all during her first pregnancy—an examination in which measurements are made to enable the physician to judge whether or not there will be any obstruction to labor. A case in which a complication of this kind is found requires the greatest skill and experience in treatment, but with such treatment the life and health of the mother are almost always safe.
PRINCIPLES AND PRACTICE OF OBSTETRICS. Jos. B. De Lee, M.D., Professor of Obstetrics at the Northwestern University Medical School; Obstetrician to the Chicago Lying-in-Hospital and Dispensary, and to Wesley and Mercy Hospitals, etc. W. B. Saunders Co. 1913.