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that the risk of allowing the pregnancy to continue was too great and a therapeutic abortion was
performed in the hospital, followed by sterilisation by X-rays. The patient made an excellent
recovery.
(2) A case of chronic nephritis with raised blood pressure in an elderly woman went successfully
to full-term under dietetic treatment and both mother and baby did well.
(3) A case of severe heart disease (mitral stenosis with failing compensation) was referred to
hospital and admitted for treatment. Two months later she had a normal confinement and both
mother and baby did well.
(4) A case of pulmonary tuberculosis in a young woman, who was being treated by induction of
artificial pneumothorax, was seen at one of the clinics. The patient successfully withstood the
strain of pregnancy and labour, and is being kept under careful observation; meanwhile, she and
the baby are apparently in excellent health.
(5) A young woman who had suffered from tubercular peritonitis in childhood had considerable
pain throughout her pregnancy from the stretching of old adhesions, but had a normal confinement
and made an excellent recovery.
(6) A considerable number of patients showed very marked anaemia; this was most common
in first pregnancies and in one case was sufficient to cause soreness of the tongue. When met with
in the older multiparae it seemed usually connected with poverty and malnutrition, but this was not
the case with the younger women. Considerable improvement was obtained in all cases by the
administration of iron and sometimes by the addition of liver to the diet; the good effect seemed
enhanced when a preparation of vitamins A and D was given in addition.
(7) A series of patients who attended the Campden Hill infant welfare centre suffering from
debility were given a vitamin A and D preparation during pregnancy and showed a very marked
clinical improvement. It appeared also in these cases that the general health was regained more
rapidly after the confinement.
B.—Diseases associated with pregnancy.
Seven cases of pyelitis of pregnancy were met with in the clinics; five of these were sent to their
own doctors and two to hospital for treatment. All the mothers did well; one baby was born
prematurely and did not survive.
C.—Complications of pregnancy.
(1) A contracted pelvis was found in seven cases. Five of these were carefully watched, but
were allowed to continue to full term; three had a normal though rather prolonged labour; two
were delivered by forceps. All these mothers and babies did well. Two cases were treated by
premature induction of labour in hospital; in one case the result was entirely successful, but in the
second case the baby was stillborn after a difficult forceps delivery ; the mother made a good
recovery. In the latter case the induction had been delayed for several weeks after the patient had
been sent to hospital.
(2) External version for breech presentation was performed in the clinics in 46 cases, 19 of these
being primigravidae. All of these women had subsequent normal confinements. In four cases
of extended breech presentation in primigravidae version was found to be impossible. These four
patients were all referred to hospital where version was again attempted under a general anaesthetic.
One case was successfully turned and had a normal confinement; in the other three cases, version
was impossible even under anaesthesia. One of the patients had a subsequent spontaneous delivery
but the baby was stillborn; the mother made an excellent recovery. The other two cases were
delivered by caesarean section and both mothers and babies did well.
(3) A transverse lie of the foetus was rectified in eleven cases, all of whom were multiparae; all
had subsequent normal confinements.
(4) Four cases of hydramnios occurred; in one of these cases an anancephalic foetus was born;
in a second case the condition was associated with twin pregnancy and albuminuria. All the mothers
did well.
(5) Retroversion of the gravid uterus was successfully replaced in one case and the pregnancy
continued to full term.
(6) Vomiting of pregnancy was excessive in 12 cases, but never necessitated admission to
hospital. Many of the cases were associated with domestic worries.
(7) Albuminuria of pregnancy was treated in 19 primigravidae and 11 multiparae. In the
former class, 15 were cured by diet and four were referred to hospital, where induction of labour
was necessary in three cases. Nine of the multiparae were cured by diet and two admitted to hospital;