Winckel,sfinally, went over the whole ground again, and arrived at the following conclusions: 1st. The rise of temperature in normal labor oscillates between 97.88° and 100.4° F. The average is 99.4° F.
2d. The temperature of a parturient in good condition is slightly higher than the normal human temperature, but this excess of tempera ture is small and does not exceed on an average 0.3 to 0.5° F. • 3d. The temperature in normal parturition is higher than during nor mal pregnancy; this excess of temperature is on an average 0.02° to 0.04°.
9th. The course of temperature in normal labor corresponds to the diurnal curve. of ordinary temperature. It shows two maxima: from 8 to 10 A.M.-99.68°, from 4 to 8 and two minima: from 12 noon to 2 P. M.-99.44°, from 2 to 4 A.M.-99.26° F.
5th. The difference between the maximum and minimum in the partu rient, is like that existing in a non-gravid female in good health; it is on an average 0.27° F.
6th. During the stage of expulsion the temperature seems to rise a little higher than during the stage of dilatation, but the difference is insignifi cant: from 99.419° to 99.476° F.
7th. There is no difference between primipane and multiparte regard ing the temperature, and the maximum or minimum.
8th. Immediately after parturition and delivery, the temperature, as compared with that during labor, varies according to the time of day when it is taken; that is to say, it diminishes at the hoar when the normal remission occurs, and rises corresponding to the regular diurnal elevation.
9th. Immediately after labor, the temperature rises above that during delivery, but the difference is very slight.
10th. As in women in health, the temperature of the parturient female in good condition is much more constant than pulse and respiration.
Peter, who measured the uterine temperature before, during, and after labor, arrived at the following conclusions: In women at term, the intra-uterine temperature oscillates about 99. 86° F.; that is to say, it is F. higher than the normal intra-uterine mean in a state of vacuity, which is, 99.5' F. The axillary temperature remains normal. During labor, the temperature of the uterus increases on an average by F.; that of the axilla by F. After delivery, the mean uterine temperature is 100.7° F.; or 1.26° higher than the nor mal mean, or 0.9° F. higher than before labor.
According to Hennig, the intra-uterine temperature rises during the contraction, at most by 0.18° F., and the axillary temperature also rises during the contraction, while Frankenhauser states that it diminishes.
Respiration: The following conclusions are likewise drawn by Winckel: 1. The frequency of respiration in parturients is greater than in preg nant women, and in women not in labor, 20.7 to 18.7.
2. The frequency of respiration is notably greater in the intervals than during the contractions. The difference between these two states is 6.8 per minute.
3. Respiration remains normal in the ascending period of the contrac tion. It diminishes at the acme, to become in the declining period of the contraction.
4. Respiration goes on accelerating in the intervals of contractions, in proportion as labor progresses and the contractions become stronger; on the other hand, it diminishes all the more during the contraction.
5. The mean in primiparte is 21.5, in multipane 20.4.
6. The frequency of respiration runs parallel to the elevation of tem perature; it diminishes as the temperature falls.
Digestive Functions.
The digestive functions, usually little interfered with at the beginning of labor, participate in the general disturbances parturition impresses upon the system. Some patients are tormented with nausea and vomiting from the onset of labor; in others, vomiting is altogether absent, but it is frequently observed at the time dilatation is completed, and also when the head passes the cervix.
Finally, Gassner has shown by his observation on one hundred and ninety cases, that a woman loses on an average, in consequence of parturi tion, fourteen and a half pounds of her weight, or almost the ninth part of the weight of a pregnant woman who reaches the tenth lunar month of pregnancy (a mean of 10.45 per cent.). This figure represents the weight of the ovum, of the blood lost during delivery, of the excrement expelled during the labor, and the cutaneous and pulmonary exhalations. After twin pregnancies, the loss amounts to 13.2 per cent. It is less in primiparse than in pluripane (Naegel6 and Grenser).
The foetal circulation and respiration are chiefly influenced by labor. During the contraction, the foetal pulsations are at first accelerated, then they diminish in frequency, and even cease altogether when the contrac tion is prolonged and vigorous. As the festal respiration is intimately connected with its circulation, interference with one unfortunately im plicates the other. Under normal conditions, the foetus within the uterus is in a state of splices, and it is only when its utero-placental circulation is interfered with, and the oxygenation of its blood thus prevented, that the foetus endeavors to supplement this placental respiration by inspira tory efforts. But the latter cause the penetration into its respiratory passages of liquor amnii and meconium instead of air, and seriously jeop ardize its life. Still, in certain cases, especially face presentations, where the mouth of the foetus is in line with the anterior part of the vagina, when the foetus makes respiratory efforts before being delivered, its air passages may aspirate a certain amount of air, which, though minimal, may suffice to save its life. It is in these cases that a peculiar pheno menon has been observed which has been termed the intra-uterine cry. The infant, still within the maternal organs, cries before being born. Though so rare that it has been disputed by Velpeau, this intra-uterine cry may occur, for it has been most precisely demonstrated by Baude locque, Huguier, Depaul, Hubert de Louvain, Heyfelder, and Winckel.