There is no clear proof that pregnant women are especially liable to infection by influenza, but there is always a notable fall in the birth-rate after marked epidemics of the disease. This has been observed in France, Germany, and Switzerland. When it does occur in pregnancy it is likely to cause abortion. Pasquier, as early as 1410, noticed this fact. The disease is likely to cause hemorrhage from the uterus in non-gravid women, especially in those who are past the climacteric, and menorrhagia in younger women who are not pregnant. Moeller[146] found abortion or premature labor in 28.3 per cent. of twenty-one severe cases. In severe influenza where there is diffuse capillary bronchitis, pleuropneumonia, or spasmodic cough, abortion is most likely to occur, and such abortion is always dangerous. The hemorrhages in abortions from influenza are often alarmingly profuse. [146] _Deutsch. med. Wochensch._, 1900, No. 28. In threatened respiratory or cardiac failure in influenza complicating pregnancy there may be question of therapeutic abortion, but in such an event great care must be taken to avoid exhaustion and shock. The child should be extracted; the woman should not be made to labor. One of the important moral considerations in this matter of influenza and pregnancy is that the woman commits grave sin if she needlessly exposes herself to infection, because of the danger to the child's life and the risk of its loss without baptism, and also because of the danger to her own life. Scarlatina (Italian _scarlattina_, Low Latin _febris scarlatina_), or Scarlet Fever, is very rare in pregnancy. Popularly, scarlatina is used for a light form of scarlet fever, as varioloid is used for a light attack of smallpox; but physicians do not make this distinction between scarlatina and scarlet fever: they use the terms synonymously. In Nothnagel's _Encyclopedia of Practical Medicine_ Juergensen has an elaborate discussion on the differentiation between genuine scarlet fever in the puerperium and the relatively frequent septic erythema found in that state, but the received opinion now is that real scarlet fever is very rare in pregnancy. Those who report large numbers of scarlet fever cases in pregnancy err in diagnosis. The mortality in the scarlatina of pregnancy may be very high--52 per cent. in some epidemics; and if the infection happens immediately after delivery, the mortality is still higher. A septic rash is sometimes mistaken for scarlatina, but where the genuine disease is present the pregnant woman is gravely obliged to avoid exposure to it, both for her own sake and for that of the fetus. In the early months of gestation scarlatina commonly causes abortion.