[143] _Annales de Gynécologie._ June, 1889
Randall, in a study of 190 pregnant women who had pneumonia, found a somewhat lower mortality than that observed by Wallich. In Randall's series 70 died (36.7 per cent.); of 118 who did not abort, only 12 died (10.7 per cent.). In a second group of 352 cases abortion happened in 58.8 per cent. Of 144 patients in the first six months of gestation, 22.08 per cent. died, but of those that aborted 52.08 per cent. died. Again, of 164 cases in the last three months, 30.49 per cent. died, but 70.12 per cent. died of those that aborted during these three months. Of 82 that aborted, 87.8 per cent. died. The mortality in women under 25 years of age was 13.33 per cent.; in women from 25 to 35 years, 23.2 per cent.; over 35, 22 per cent.
Pneumonia in pregnancy is made worse by the mechanical interference with respiration brought about by the enlargement of the uterus, and the heart, which is overburdened in ordinary pneumonia, is still more exhausted by the additional strain of pregnancy in the pneumonia of gestation; moreover, the lungs, which are obliged to do enhanced labor in pregnancy in eliminating, are clogged by the pneumonia; it would seem, then, that, if the fetus is viable, the womb should be emptied to give the mother a better chance for recovery. Statistics, however, are against therapeutic abortion. The evacuation of the uterus determines blood to the inflamed lungs, which are already overburdened. The exhaustion of labor weakens the patient, and makes her liable to general septic infection. Matton[144] found that in eighteen cases where pregnancy was artificially interrupted, nine women died (50 per cent.); while in twenty cases where no interference was attempted, only one woman died. This comparison is not exact, perhaps, because we do not know the gravity of the infection in each group, but in any consideration the difference is remarkable. In a group studied by Chatelain[145] the results in natural and artificial delivery were virtually the same. Inasmuch as therapeutic abortion at the best is no better than non-interference, there is no justification for therapeutic abortion, unless in unusual circumstances.
[144] _Jour. de Méd. de Bruxelles_, 1872, p. 412.