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41
month of life. Such deaths are mostly due to the physical condition
of the mothers during pregnancy and are therefore largely preventable
by ante-natal care. I am glad to be able to record that only 8 Hampstead
babies whose mothers had attended our Clinics died below the
age of 1 month. The neo-natal death rate (which term is used to
describe the number of infant deaths occurring in the first four weeks
of life) was only 26 per 1000 amongst the babies of our patients. I
do not think that one could have done any more to prevent these
deaths, than was done. For example, two children died at 4 days old;
children of an unmarried mother who only came to the Clinic once and
did not return. A third infant died at 4 weeks of age from toxaemia
due to an infected cephalhematoma after a normal confinement.
A fourth child, healthy at birth, died of pneumonia at ten days old.
A fifth child died at 3 days of cerebral haemorrhage due to rapid
moulding of the head and delivery. No disproportion or pelvic contraction
had been noted beforehand. A sixth child also died of
cerebral haemorrhage in the second week of life. In this case forceps
had had to be used owing to bleeding before delivery. The seventh
and eighth infants died owing to prematurity. In one of these, I had
only seen the mother for the first time the day before her confinement
and had sent her into New End Hospital promptly, as the membranes
had ruptured two or three weeks previously. In the other one, I had
suspected the presence of syphilis in the mother before her child's
birth owing to her history, but a blood test taken some time previously
had been negative as regards the Wasserman reaction and all my
efforts to induce her to go to the Royal Free Hospital and have
another blood test (after a provocative injection of novarsenobillon)
had proved fruitless.
I am glad to say that there were no maternal deaths amongst
the Hampstead mothers who attended the Clinics.
Abnormal Cases.
Six expectant mothers were found to be suffering from valvular
disease of the heart, due to rheumatism in childhood or youth. The
mitral valve was affected in all cases and the aortic as well, in one.
The latter patient decided to go into St. Mary's Hospital, Paddington,
for her confinement and I sent her to the ante-natal clinic there with
a note to the doctor in charge, who kept her under observation during
pregnancy. A Caesarian section was performed and both mother and