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34
Of these 14 positive results—
5 were discovered before the 7th month of pregnancy
9 were discovered after the 7th month.
Thirteen post-parturient cases had positive results.
B.—For the examination of pregnant and post-parturient
women suffering from vaginal discharge and sores and
irritation about the vulva.
All pregnant patients suffering from more than a very
slight vaginal discharge are referred to the "Special"
Clinic and are there examined with the proper facilities
and films are taken from urethra and cervix when necessary.
Many patients are found to require no treatment. In
1925 19 films were taken from the cervix, gorococci being
discovered in only two cases.
These two patients received in addition to weekly
inspection and treatment by the doctor, daily douching,
etc., by a nurse and were discharged cured.
Besides these two cases, any case showing a purulent
or excessive vaginal discharge received treatment and
among these were several cases of cervical erosion of
probably infective origin.
The work of this Clinic and its results may be summarised as
follows :—
1. A routine Wasserman test is an extremely valuable and
essential part of ante-natal examination.
2. The importance of an examination in all cases complaining
of a possible purulent discharge during pregnancy. It is
possible that some of these discharges originated in a
Diplococcal infection, but the gonococcus is seldom
found in pregnancy unless the infection is recent and acute.
In films special attention should be paid to the number
and staining re-actions of pus cells—large quantities of well
staining pus cells being an absolute indication for treatment.
Treatment should be started as early as possible
in pregnancy, as local treatment, except in very severe and
acute cases, is not usually desirable after the 8th month.
For this reason, and in order that the routine Wasserman
test may be carried out patients should be encouraged
to report very early in pregnancy, e.g., the 3rd month, when
this examination can be carried out.
They could then be required to attend again 2-3
months later, when the usual examination, i.e., presentation
of foetus measurements, etc., could be carried out.