Lying in wait for a cure for preeclampsia
May 22, 2019
Before modern times, women feared childbirth as a life-threatening event. In the 1800s, mothers died from childbirth at an alarming rate. Puerperal fever, a uterine infection contracted after childbirth, accounted for 40 to 55 percent of maternal deaths. Toxemia, commonly referred to as preeclampsia, caused another 20 percent of maternal deaths. Physicians and researchers were unclear of the causes, let alone the cures, for puerperal fever and preeclampsia. Joseph Boliver DeLee, MD, regarded as “the father of modern obstetrical care,” was committed to change that.
“He was a passionate and unrelenting crusader for women’s health,” said Mindy Schwartz, MD, an internist at the University of Chicago Medicine and the resident historian of the academic medical center.
DeLee was a Chicago physician who dreamed of establishing a hospital that only cared for pregnant women. Not only did he want to cure diseases like puerperal fever and preeclampsia, but he also wanted to make care for women more accessible and more sanitary. DeLee started by creating a dispensary that delivered medication to women in the community. The dispensary grew into an outpatient clinic that provided maternity care to the needy. He also trained medical students, nurses and interns from around the world in obstetric care.
By the end of 1895, DeLee delivered 204 babies at his clinic. By the end of 1896, he trained 12 physicians and 52 nurses. In 1917, he opened the first Chicago Lying-in Hospital, which became the model for maternity care worldwide. According to the Chicago Lying-in Hospital Board of Directors, a group of volunteers committed to advance the care offered by the Chicago Lying-in Hospital, DeLee’s archetype vastly helped to reduce epidemics of puerperal fever.
DeLee was at the forefront of obstetric care, so partnering with the University of Chicago was a natural progression. In 1931, under DeLee’s direction, the Chicago Lying-in Hospital opened on the corner of 59th Street and Maryland Avenue. The location was near, but deliberately separate from, the University's other hospitals to reduce contamination and keep women healthy.
“We think it is the most beautiful hospital in the world, and it stands as a monument to childbearing women and to the dignity of obstetrics," said DeLee.
Over the years, the Chicago Lying-in Hospital at UChicago Medicine was home to many firsts and discoveries. The hospital housed one of the nation's first premature infant nurseries. It was also the site of the first portable incubator used to treat premature babies. Chicago Lying-in Hospital was even the site of the first medical motion picture. However, even after DeLee gained a firm grasp on the cause and treatment of puerperal fever, preeclampsia eluded him.
Near the top of the cloister on the Chicago Lying-in Hospital building, passersby can see five stone placards, four of which bear the names of clinicians who made great contributions to the field of obstetrics and gynecology.
Jan Palfyn (1650-1730), a Flemish surgeon and obstetrician, is remembered for his obstetrical forceps introduced in the early 1720s. Hendrik Van Deventer (1651-1724), an obstetrician and orthopedist, is honored for discovering anatomic abnormalities that could contribute to obstetric issues. William Smellie (1697-1763), whom DeLee greatly admired, is commemorated for improving the design of the obstetrical forceps as well as his organized and masterful teaching of midwifery. Eduardo Porro (1842 – 1902) is remembered for successfully performing a hysterectomy during a C-section to stop another major complication of delivery – postpartum hemorrhage.
The fifth, center placard is bare. Legend has it, according to Schwartz, the placard has been lying in wait for the last 90 years until a doctor or medical researcher finds the cause and cure of preeclampsia, rounding out DeLee’s vision for women’s health.