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I should like here to make some comments and suggestions
about these results having a close connection and interest with
these cases by reason of my Ante-Natal work.
Albuminuria.—Although 64 cases of Albuminuria were seen
at the Ante-Natal Clinics and there treated it was only necessary
to admit 4 cases to the Hospital. Of these 3 became Albumenfree
after in-patient treatment, and the other patient was transferred
to St. Thomas's Hospital with grave Ophthalmic symptoms. In one
case Eclampsia occurred.
Breech Presentations.—I think it is a matter for congratulation
to all concerned in the examination of the Ante-Natal patients
that out of 906 new patients only 5 cases of breech presentation
escaped diagnosis. Seventeen breech cases were admitted for a
night to the Hospital for External Version under anaesthesia and
in 7 of these version was successful. Of the remaining ten labour
resulted in the birth of a living child in all but one case, i.e., 90
per cent., which is a matter for the warmest praise of the Matron who
performed most of the deliveries in these often, in primiparae,
very difficult cases.
Inductions.—During 1926, 13 inductions were performed (one
was followed by Caesarian Section with a live child, but unfortunately
death of the mother 3 days afterwards—? cause) as against 3 inductions
in 1925. This at first appears a large increase, but when
the number of primiparae attending the clinics is taken into
consideration I think this increase is relative only and that the
actual ratio number of inductions will have altered little.
number of primiparae
These inductions resulted in the birth of 8 living children, of
whom 2 died shortly after birth with convulsions, apparently
arising from cranial injury. One mother died (? from Embolism),
and one mother had for a time continued pyrexia.
These results are disappointing and require further scrutiny.
Of these 12 inductions, 6 were sent to St. Thomas's Hospital for a
second opinion, in these cases some doubt being felt as to the
best time to perform induction or as to the necessity and suitability
of a case for induction. In all these cases its carrying out was
advised, either at once or at a future date. These 6 cases resulted
in 5 forceps deliveries with 2 still-births and 2 neo-natal deaths.
The 6 remaining cases were seen by me only and resulted in
4 living children and 2 still-births, neither of the cases in these 2
last requiring assistance by forceps, therefore presumably labour
was quite easy.
Certain conclusions may be drawn from these data:—
(1) It is a well-known fact that induction babies stand
instrumental interference very badly, their prematurity
and consequent lessened cranial ossification making them