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Maternal Mortality.
There were 11 deaths due to pregnancy, of which 5 were due to
sepsis, giving a maternal mortality rate for sepsis of 2.50, and for
other accidents and diseases of pregnancy and parturition 9, with
a total rate of 7.22.
Two of the scptic cases followed abortions following which
there was a long delay in obtaining treatment. Two cases followed
operative interference for obstruction during the confinement.
In one instance, the child was large and induction would probably
have prevented a fatal issue. In the other, efficient ante-natal
supervision would probably have detected the cause of obstruction
and averted the trouble. The other case of sepsis followed an
apparently normal delivery.
Three eases of eclampsia proved fatal. In not one of
them was ante-natal supervision satisfactory in spite of a previous
history of kidney trouble. In two of the cases, the urine was not
systematically examined.
Hæmorrhage through obstructed labour accounted for two
deaths. Both of these seem to have been avoidable by ante-natal
supervision and treatment.
Two eases died in spite of early admission to hospital, one
suffering from hæmorrhage from placenta previa and the other
suffering from hyperemesis.
Of the remaining two fatalities, one was a case of pulmonary
embolism following an apparently normal uncomplicated confinement.
The other died of pneumonia subsequent to a cæsarian
section performed owing to disproportion of head and pelvis.
For purposes of comparison of maternal mortality rates, the
present system of certification leaves much to be desired. ln sonic
cases, " pregnancy " appears on a death certificate of a case in
which this had actually no association with the fatal issue. More
serious is the fact that in many cases there is no mention of pregnancy
in eases in which it or the labour was definitely associated
with the death. In other instances an antecedent abortion or
miscarriage leads to a condition which terminates fatally, but in
which the death certificate records only pneumonia or sonic other
illness.
Investigations into maternal mortality due to pregnancy and
child birth as suggested by the Maternal Mortality Committee of
the Ministry of Health are carried out by the Medical Olliccr of
Health.