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of the old scar (Caesarian Section). The tear was sutured and two
further blood transfusions given. Unfortunately the operation
wound became infected and she developed a fistula, and an infection
due to B-coli and Haemolytic Streptococcus followed by a double
basal pneumonia ; she died on 23 rd May due to Toxaemia, following
wound infection and pneumonia, following operation made imperative
by rupture of the uterus.
Inquest.—An inquest was held owing to the history of being
knocked down by a lorry, but it was considered that this had no
connection with death.
Summary.—This woman had expert skill and attention in Hospital
and died from toxaemia, peritonitis and sepsis following rupture
of the uterus, a complication stated to occur only in 1 in 3,000 to
5,000 deliveries : 94 per cent. occur in multipara; the maternal
mortality varies from 60 to 80 per cent., the prognosis therefore is
very grave, death occurs most often from sepsis, as in this case.
It would appear that this death could not have been prevented.
2. A woman was admitted to the Archway Hospital, Archway
Road, Highgate, on 9th January, 1938, in a dying condition. She
was about ten weeks pregnant, and had had no ante-natal care;
neither had she made arrangements for her confinement with a
Hospital, Midwife or General Practitioner. She had no children.
She had suffered from heart disease and bronchitis for years,
and had complained of shortness of breath for two years, and had
gradually been getting worse for the last six months, her ankles
swelling.
Two hours before admission she had a severe haemorrhage from
the vagina, and on arrival at the hospital she was very collapsed and
short of breath. No further haemorrhage occurred whilst in hospital.
In spite of treatment, she died the same day.
A post-mortem examination was performed and revealed all the
signs of " failing heart," a " Heart Failure " lung and liver.
The death was due to failure of a rheumatic heart, the pregnancy
having no connection with death.
Summary.—This woman died from heart failure, but as she was
at the same time about ten weeks pregnant, her death was registered
as " associated with pregnancy and childbearing."
The death is not a " Maternal Death " of common parlance and
as usually understood.