A survey of two hundred five gynecologic deaths, 1938 to 1950

1.1. Two hundred five consecutive gynecologic deaths over a thirteen-year period were reviewed.2.2. Malignancy of the genital tract accounted for 56 per cent of all the deaths.3.3. Although 51.5 per cent of the patients admitted to the gynecologic ward were Negroes, they accounted for only 25 per cent of the deaths from malignant disease, and for 61 per cent of the deaths from benign disease. The explanation lies in the higher incidence of septic abortion and pelvic inflammatory disease among the Negro women admitted to this institution.4.4. Carcinoma of the cervix was responsible for more than half the deaths from malignant disease. Routine vaginal smear and biopsy of the cervix probably would sharply reduce the incidence of deaths from this cause.5.5. Earlier treatment in the malignant disease group can be achieved through better education of the laity and medical profession. This lack is indicated by the large number of patients admitted to the hospital in poor or moribund condition, and the inadequate medical care given to 30.4 per cent of the patients.6.6. The average age at death from malignancy of the genital tract was in the fifth decade, whereas that from benign disease occurred in the third decade.7.7. Abortion and pelvic inflammatory disease were responsible for 20.5 per cent and 13.7 per cent, respectively, of the deaths from benign disease.8.8. While there has been no significant decline in the death rate from abortion, that from pelvic inflammatory disease has been virtually eliminated. In large measure this decline has been due to antibiotics and more radical surgery for the latter condition.9.9. Concealment of criminal induction by the patient is partially responsible for the continued high mortality rate from abortion, despite antibiotics and blood transfusion.