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disturbances of vision were noted in 3 cases and slight headache in 6.
Extreme swelling of the lower limbs was noted in 4 cases. One
woman with a rising diastolic pressure, displayed symptoms of a small
concealed haemorrhage of the uterus in the last three weeks before her
confinement, so I sent her into New End at once for rest and treatment.
I was obliged also to send 4 other women out of these 15 into
New End for a rest before their confinements, for periods varying
from a few days to 3 weeks. One of them had only a slight rise of
blood pressure and a trace of albumin in the urine, but she was complaining
of sickness and headache and " spots in front of the eyes,"
which are always danger signals. The remaining 3 people were sent
into New End as the blood pressure in each case had risen to 170/105,
185/105, and 145/105 respectively. The latter woman subsequently
developed mild eclampsia (without fits) during the second stage of
labour and the first two days of the puerperium, but she made a good
recovery subsequently and the baby was alive and healthy. This was
a highly satisfactory denouement. I find that the remaining 25 patients
out of our series of 26, passed through their confinements without any
symptoms of eclampsia and healthy babies were born, with the
exception of 3 cases where a still birth unfortunately occurred. An
investigation showed, however, that 2 of these were almost certainly
due to difficult labour and not to any toxic condition present, but the
third case of stillbirth was undoubtedly caused by the toxaemia present
in the mother before delivery. She had had a high blood pressure and
albuminuria but had entirely refused to go into Hospital for a rest
before her confinement as we had urged her to do.
With regard to the case of eclampsia noted above I am glad to
record that it is the first case I have come across since the year 1927.
I have followed up most carefully (as far as possible) all cases of
toxaemia of pregnancy met with at the Clinics and (if I except the year
1933, when I could not carry out the usual researches owing to illness)
I find that, of a series of just over 1,900 Hampstead mothers attending
the Clinics, I have only been able to trace this one case of
eclampsia, and that a mild one without any fatal results.
This little investigation therefore confirms me in my belief that
the frequent observation of the expectant mother and testing of her