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135
Results of examination of 268 of the 1935 cases:—
Medical.
Anaemia 64
Dental disease 58
Malnutrition 22
Mitral disease 8
Renal disease 6
Various 16
Gynaecological.
Subinvolution 40
Erosion and Cervicitis 18
Retroversion 8
Weakness of abdominal muscles 11
Damaged nipples and mastitis 9
Severe perineal laceration 1
Various 7
Subinvolution with haemorrhage persisting for more than a month
after delivery is practically always associated with anaemia. There were
19 women with this combination in whom the haemoglobin averaged
64 per cent.; two were under 30 per cent.
They improve so quickly after a short course of ergot followed by
iron that we again call attention to the value of ergot for many women
during the lying-in period.
Another fact which again emerges is the importance of iron therapy
in all cases where haemorrhage above the normal has occurred in connection
with labour. Two patients who were known to have had over 80 per cent.
of haemoglobin towards the end of pregnancy were found to have fallen
below 50 per cent. when seen after delivery, and haemorrhage seemed to
have been the most probable reason. In another where it was known to
have occurred 32 per cent. of haemoglobin was found three weeks after
delivery. It rose to 79 per cent. in nine weeks on full doses of iron. These,
and many others which could be quoted, show the benefits which follow if
treatment be started before the women become accustomed to being
anaemic. Once this has happened it is surprisingly difficult to persuade
them to persevere with the necessary dosage.
Haemoglobin estimation was made in 124 patients.
Haemoglobin. Number.
Above 75% (Average 82%) 47
50 to 75% (Average 67%) 56
Below 50% (Average 42%) 21