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
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.