Pulse and Temperature

Categories: Obstetrics or Midwifery

The temperature may rise one to one and one-half
degrees without the case being abnormal. The pulse falls after labor,

ranging between sixty and seventy. A rise of temperature, a rapid pulse, a

flushed face, a chill, pain or tenderness of the abdomen, and abnormal

increase or decrease of the discharge, bleeding, or offensive odor of the

discharge should cause suspicion of child-bed (puerperal) fever. This is a

grave condition and results from infection which has taken place during

labor or afterward. The septic matter may be carried in on the fingers or

instruments by the physician or attendants, etc. The most usual sources

are unclean hands, instruments and clothing which come in contact with the

woman's genitals. The attack is usually ushered in during the second to

the fourth day by a chill, or chilly sensations, etc., rise of

temperature, rapid pulse, accompanied by headache and a feeling of

weariness. The discharge may be increased at first, but later diminished

and may cease; or it may be abundant, frothy and of a very fetid odor.

Secretion of milk may fail, the bowels are usually constipated, pain in

the abdomen develops.



Treatment. If the interior of the womb is smooth, a single antiseptic

womb injection should be given; if it contains foreign material or is

rough, it should be scraped and then a douche given. This must be done

carefully and with absolute cleanness. Turpentine stupes should be placed

hot on the abdomen for the pain, or where cold feels more grateful the ice

bag or cloths wrung out of cold or ice water should be applied over the

abdomen, and covered with several thicknesses of flannel and changed as

soon as they become heated. Medicines to relieve the pain may be given.

Hot and cold sponging may be given to reduce the temperature, a little

alcohol can be added to the water or the cold or hot pack may be used.






Diet. This should be nourishing and supporting, and at first, liquid and

consist largely of milk; but concentrated broths, jellies, and liquid

beef, peptonoids, are useful. Stimulants should be given in these septic

conditions. From one to two ounces of whisky may be given every three to

four hours in the form of milk punch and, if possible, as much red or port

wine also. Women in this condition can stand this treatment. Salines

(salts) should be given to keep open the bowels.