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67
The term "associated with childbirth" includes causes of death which
have no special connection with the puerperal state ; for instance, one death
in Finsbury in 1938 was due to failing heart and one to Graves disease and
broncho-pneumonia, giving a total maternal mortality for Finsbury of 4.05
per 1,000.
As will be seen from the above table, the Borough of Finsbury
has an exceptionally good record, the maternal mortality being on
the average less than that of London as a whole and England and
Wales. In the report of the Ministry on an investigation into
maternal mortality, Finsbury was included in Group D areas, i.e.,
those areas where the rate is lower than that of England and Wales
by 20 per cent. or more.
I have set out below particulars regarding the three deaths
due to or associated with childbirth.
Maternal Deaths.
I. This woman had one previous pregnancy in 1937, when it
was found necessary to perform an operation for the removal of the
child on account of Placenta Praevia.
Ante-Natal Care.—She originally booked for her confinement
on 21st January; her physical condition was stated to be good and
the blood test normal. She paid six visits to the Ante-Natal Clinic
up to the 20th April and she was found to be progressing favourably
She attended again on 20th April owing to the fact that she had
been struck by a motor-lorry in the street on that day, and wondered
if any harm had been done; no indication could be found by the
Hospital that any trouble had resulted therefrom.
She was visited in her home on three occasions in the next five
days but no abnormality in the pregnancy had developed.
She re-attended again on 26th April and was admitted to await
the labour which was expected on 3rd May.
On 27th April labour began and progressed normally without
obstruction until 4.30 p.m. on the 28th April, when she suddenly
collapsed.
Diagnosis.—This patient was extremely shocked and collapsed
and was immediately given an intravenous injection of gum-saline
followed by blood transfusion, as she was diagnosed to have a
ruptured uterus. As soon as she had recovered from the shock, an
operation was performed, and a still-born child removed from the
abdominal cavity, the uterus having ruptured throughout the length