Menstrual Intervals

MENSTRUAL INTERVALS JESSIE

L.

KING,

Pu.D.,

BAL'l'IMORE,

1\Tv.

(From the Department of Physiology and Hygiene, Goucher College)

years ago the detailed menstrual records of 17 women covering A FEW Sixteen of the subjects were 523 intervals were published (King 1

).

college women and the majority were students or were engaged in professional work. The ages ranged from nineteen to thirty-five years, 6 were over thirty and 5 were under twenty-five. For one member of the older group the record of the first 24 periods after the onset of menstruation was included. In this series, the most frequent interval, twentyseven days, occurred 97 times and the remaining 426 intervals ranged from eighteen to thirty-seven days. It is still the general opinion that the normal woman in good health has a twenty-eight-day cycle and that there are only slight irregularities of occurrence. Since this report showed rather wide variations, it has been criticized on the ground that the average age was high and that college and professional women do not form a representative group. The great interest at the present time in the physiology of the reproductive cycle, justifies the presentation of additional data, largely from a younger group, which includes some industrial workers. It supports rather strikingly the former conclusion. I am indebted to the medical service of the Eastman Kodak Plant at Rochester, and of the Western Electric Plant of Baltimore for the records of women in industry. It is not easy to find, even among college students, a group which has sufficient interest to keep an accurate record for periods long enough to be of value. It is naturally even more difficult with industrial workers. The report presented herewith is based on the records of 37 women and includes 354 menstrual intervals. The number of intervals for a subject varies from 4 to 27. The 21 industrial ,,·omen include machine operators, shop clerks and one secretary. There is also one maid. Of the other 16 women, one was a laboratory assistant, one a medical student and the others college students. Fifteen members of the entire series were from seventeen to nineteen years of age, 22 were between twenty and thirty-five. The data are tabulated according to occupational groups and then are charted, first on the same basis and then according to age. Those under 20 are included in the first age chart and those from 20 to 35 in the second. The average irregularity of the intervals between the periods, whichever way the material is arranged, is even more obvious than that shown in the former study. This may be due to insufficient data or it may be because the average age was lower and the regularity of the cycle not as well established, 37 per cent of the intervals occurred in women under 583

'l'otal

Inspector of boards on conveyor Shop clerk Operator machine Shop clerk Light ''sitting work '' Machine work with great vibration Operator of foot machine Clerk (married) Housemaid Filing Seeretary Braider, machine operator Sitting at work Charge of mail department A[achine operator Standing and walking all day Operator, foot machine Walking all day Heavy hand work (widow) Sitting at work Standing and walking

INDUSTRIAL WOMEN

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TABLE II. THE FRI!:QCENCY OF 0CCCRRI!:NCE OP lJIJ<'~'EitEN'!' INTERVALS, AcCORDING '1'0 AGE Gr.OUPS

586

AMERICAN JOUI~XAL O:B' OBSTETRICS ,\!\D GY:KECOLOGY

twenty. No conclusions can be drawn as to the cliffrrence between the college and industrial groups. In the earlier series 18.5 per cent of the occurrences were at the twenty-seven-day interval. In the present series the most frequent intrrral wa!'-: ag·ain hn>nt:v-sevPn days awl the pl'r et'nt was

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14.4. Intervals of twenty-eight, twenty-nine, and thirty days were close in number to the maximum interval. Fifty-six and seven-tenths per cent of the 354 occurrences are included in the twenty-sixth to the thirtieth days, while in the former series the twenty-fifth to the twenty-ninth days included the greatest number, 66.7 per cent.

DEMBO : HEM ORIUI AGE IN NEWBORN

587

SUMMARY

Accurate data on the frequency of menstruation in 37 industrial and college women is reported. The series includes 354 intervals. rms work supplements previous records on an older college group and supports the conclusions drawn from it on the irregularity of the occurrence of menstruation in normal women. REFERENCE

King, J. L.: Contributions to Embryology 18: Carnegie Inst. Wash. Pub. No. 363, pp. 79-94, 1928.

AN ANALYSIS OF 55 CASES OF HEMORRHAGE IN THE NEWBORN* LEON

H.

DEMBO, M.D., CLEVELAND, OHIO

(From the Departments of Obstetrics and Pediatrics of St. Luke's and St. Ann's Hospitals)

hemorrhages are responsible for a large part of the neonatal BIRTH death rate. Intracranial hemorrhage has been reported present in as high as 50 to 75 per cent of deaths of newborns. Of the cases surviving, many show later pathologic changes which retard the physical and mental development of these unfortunate infants. Idiocy, epilepsy, and various forms of paralysis are often left in the '\rvake of hemorrhages occurring at birth. Santos, in a seriEif! of autopsies on 1387 newborns dying shortly after birth, found that in 22 per cent death was due to hemorrhage. Kowitz reported 1014 cases of intracranial hemorrhage in a series of 5,989 autopsies. In Schafer's series of 680 postmorte1n examinations, 140 sho·wed intracranial hemorrhages. r.ryson and Crawford found that 32.1 per cent of stillborns that came to autopsy had hemorrhage. Baily found the incidence to be 40 per cent in a series of 100 autopsies. Additional statistics merely emphasize the alarming frequency of this condition and its menacing role in neonatal mortality.

In speaking of hemorrhage of the newborn, I have reference to two main types: (1) spontaneous bleeding or hemorrhagic disease, and (2) intracranial hemorrhage resulting from a number of etiologic factors. The first type includes general oozing from mucous surfaces, prominent among which are those of the gastrointestinal tract. The second classification includes hemorrhage involving the brain and meninges, resulting largely from traumatism. A third classification, the so-called "hemorrhagic diathesis,'' has the aristocratic euphony of dermatologic terminology, reinforced with an etiologic vacuum. In an analysis of 55 cases, taken from two hospitals in Cleveland, the sex incidence was about equal. There were 39 (70.9 per cent) cases of intracranial hemorrhage, 15 (27.2 per cent) of the gastrointestinal type, and one (1.8 per cent) of umbilical hemorrhage. *Read hefore the Seetion on Obstetrics and Gynecology of the Cleveland Academy of Medicine, May 11. 1932.