London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1946
[Report of the Medical Officer of Health for London County Council]
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40
During 1946, 10,834 patients were delivered in their own homes by the Council's
domiciliary midwives. There were 2,478 primigravidse and 8,356 multigravidse.
A number of women booked by the Council's domiciliary midwives are admitted
to hospital suffering from toxaemia, antepartum haemorrhage, etc., and are not,
therefore, included in the foregoing number of confinements.
There were 9 maternal deaths, of which 1 died at home from pulmonary
embolism, and 8, who had booked Council domiciliary midwives, died in hospital.
There were 68 neo-natal deaths, 52 at three days or under (14 of them under
four hours) and 16 over three days; 22 were full-term and 46 premature infants;
32 were males and 36 females. In only one case was there maternal toxaemia.
The number of stillbirths was 155, including 44 premature infants. These figures do not include women transferred to hospital who were subsequently delivered of stillbirths. The following is an analysis of stillbirths:—
| No. | Sex | Full time | Prem. | Maternal toxaemia | Condition of infant | Method of delivery | Presentation | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Macerated | Not macerated | Normal | Forceps | Breech | Others | Vertex | Breech | Others | |||||||||
| M. | F. | ||||||||||||||||
| (1) Primiparae | 34 | 17 | 17 | 23 | 11 | 5 | 12 | 22 | 19 | 7 | 3 | 5* | 27 | 3 | 4 | ||
| * 2 B.B.A., 1 hand and foot, 1 face, 1 failed forceps. | |||||||||||||||||
| MCLTTPAK/E | No. | Sex | No. where previous | Maternal toxaemia | Full time | Prem. | Condition of infant | Method of delivery | |||||||||
| M. | F. | Prem. | Neo-natal deaths | Still births | Abortion | Macer-| a ted | Not macerated | Normal | Forceps | Breech | Others | ||||||
| (2) Parity, 5 and under | 99 | 50 | 49 | 6 | 5 | 10 | 10 | 12 | 73 | 26 | 45 | 54 | 72 | 2 | 16 | 9* | |
| (3) Over parity 5 | 22 | 11 | 11 | 4 | 3 | 6 | 5 | 2 | 15 | 7 | 10 | 12 | 15 | — | 3 | 4† | |
* 2 face, 2 footling, 5 B.B.A. †B.B.A., 1 footling.
The cause of stillbirth was ascertained in 111 cases, as follows:—
In 26 out of 34 primiparae—prematurity (11), abnormality of cord (6), prolonged
second stage (5), following external version (4).
In 64 out of 99 parity 5 and under—prematurity (26), abnormalities (18), antepartum
haemorrhage (11), abnormality of cord (6), abnormal presentation (2),
influenza (1).
In 21 out of 22 over parity 5—prematurity (7), abnormalities (3), abnormality
of cord (3), following external version (2), impacted shoulders, weights of infants
llf and 11 lbs. (2), infants born before arrival of midwife (2), abnormal presentation
(1), ante-partum haemorrhage (1).
The incidence in primiparae of prolonged second stage and in multiparae of
ante-partum haemorrhage in relation to stillbirths is noticeable.