Acta Sixty Years Ago: Evaluation of Radical Treatment of Abortion Peritonitis

In the 1920s, peritonitis following abortion was an extremely serious condition, attended by a high risk of lethal outcome for the unlucky victim. Surgical intervention had been tried, but fallen into disrepute. In the first article in fasciculus I of Acta Obstet‐ricia et Gynecologica Scandinavica in 1930, J. J. Chy‐denius wrote Uber die operative Behandlung der dif‐fusen Abortperitonitiden (1), an account of the change from conservative to operative treatment of the condition. at the University clinic in Helsinki. During eleven years, 1919‐1929, the Department had treated 3221 abortees, of whom 56 (1.7%) were stricken by diffuse peritonitis. Of the latter, 27 were treated conservatively, and only one of these survived. Before 1925, surgical treatment did not seem to matter much one way or the other, as seven out of eight patients who were operated upon also died. However, in 1925 matters seemed to improve. Operative intervention became more frequent, accomplished first by small incision and drainage, later by more radical laparotomy with removal of one or both adnexa and in some cases amputation of the uterus, plus incision and drainage through the vagina. Between 1925 and 1929, nine out of 21 patients so treated survived. The author was quick to point out that the two groups (operated and non‐operated) were not strictly comparable. Both because of small numbers and der untereinander sehr verschie‐denen Eigenart der Falle kann jedoch keine statis‐tische Behandlung des Materiales in Betracht kom‐men. They were not unaware of the golden rule for statistical comparisons even in those days. Take heed, computer converts!