Bjøro K
Kvinneklinikken, Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1993 Dec 10;113(30):3712-4.
Maternity hospitals began to be established in the middle of the 18th century to relieve the distress of the poor. As the number of lying-in hospitals increased, so did the cases of puerperal sepsis. The death rate from puerperal sepsis in Norway was high and remained so until 1934. Semmelweis studied the maternal mortality rates in two obstetric clinics in Vienna for the years 1841-46. He declared that puerperal fever was transmitted by the doctors who taught in the dissecting room and went straight from there into the labour wards. I 1847 he instructed all doctors or students to scrub their hands in a solution of chloride of lime before they delivered, examined or touched any patient. The haemolytic streptococcus was finally proved to be the cause of puerperal sepsis by Louis Pasteur in 1879. There was a significant drop in mortality rates in maternity hospitals after the introduction of antiseptic and aseptic techniques around 1880. Deaths from puerperal fever paralleled deaths from erysipelas, and both conditions declined after 1934. Puerperal fever and pelvic inflammation is still a clinical problem. The author discusses sexually transmitted diseases and multibacterial causes.
18世纪中叶开始设立妇产医院，以缓解穷人的困境。随着产科医院数量的增加，产褥热病例也随之增加。挪威产褥热的死亡率很高，且一直居高不下，直到1934年。塞麦尔维斯研究了1841年至1846年维也纳两家产科诊所的孕产妇死亡率。他宣称，产褥热是由在解剖室授课的医生传播的，他们直接从解剖室进入产房。1847年，他指示所有医生或学生在接生、检查或接触任何患者之前，先用石灰氯溶液洗手。1879年，路易·巴斯德最终证明溶血性链球菌是产褥热的病因。1880年左右引入防腐和无菌技术后，妇产医院的死亡率显著下降。产褥热死亡人数与丹毒死亡人数相似，1934年后这两种情况都有所下降。产褥热和盆腔炎仍然是一个临床问题。作者讨论了性传播疾病和多种细菌病因。
