[Puerperal infections. From Semmelweis to current problems].

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.