Michigan State Medical Society

Abstract Forty-four cases of fatal puerperal sepsis in women delivered vaginally in the second half of pregnancy are presented in this 17 year study in Michigan; its importance is underscored by the fact that in 5 of the last 6 years sepsis has been the number one cause of death in that state. Premature rupture of the membranes occurred in 75 per cent of the cases; sepsis became clinically evident before delivery in 66 per cent and following it in the remainder. There were equal numbers of ante- and postpartum infections in the first 10 years of the study, while there were 3 times as many antepartum as postpartum infections in the last 7 years. The reason for this is believed to be the advent of “new,” or more pathogenic strains of common vaginal bacteria in April, 1960, because starting in that month there was a doubling of the annual number of deaths from puerperal sepsis over previous figures.