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 1952
[Report of the Medical Officer of Health for London County Council]
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The action taken by the emergency obstetric service was :
| Removed | Remained | |||
|---|---|---|---|---|
| Obstetric shock | ||||
| Blood transfusion | 1 | 1 | ||
| post-partum haemorrhage | with shock | |||
| Blood transfusion | 4 | 4 | ||
| Administration of drugs | 1 | 1 | ||
| post-partum haemorrhage | (following delivery of placenta) | |||
| Blood transfusion | 8 | 14 | 22 | |
| Plasma transfusion | — | 1 | 1 | |
| Dextrose transfusion | — | 1 | 1 | |
| Administration of drugs | 2 | — | 2 | |
| No treatment | 2 | 2 | ||
| retained placenta with post-partum haemorrhage | ||||
| Blood transfusion | 9 | 2 | 11 | |
| Dextrose transfusion | 2 | _ | 2 | |
| Administration of drugs | 1 | — | 1 | |
| Manual removal with blood transfusion . | 1 | 5 | 6 | |
| No treatment | 4 | 4 | ||
| retained placenta | ||||
| Administration of drugs only | — | 1 | 1 | |
| retained membranes | 1 | _ | 1 | |
| Administration of drugs | 1 | — | 1 | |
| Manual removal of membranes | 1 | 1 | ||
| acute inversion of uterus with adherent placenta | ||||
| Blood transfusion. Manual removal of | ||||
| placenta and replacement of uterus | 1 | — | 1 | |
| secondary post-partum haemorrhage | ||||
| Blood transfusion | 1 | — | 1 | |
| ante-partum haemorrhage | ||||
| Blood transfusion | 1 | _ | 1 | |
| No treatment required | — | 1 | 1 | |
| abortions | ||||
| No treatment | 1 | — | 1 | |
| 35 | 31 | 66 | ||
All 66 cases to which the service was called were true obstetric emergencies.
There was only one maternal death and this occurred 11 hours after an acute inversion
of the uterus. In all other cases the mother made a good recovery.
Gas and ail
Analgesia
The use of gas and air analgesia by the Council began in 1946. The apparatus is held at
selected ambulance stations throughout the county and delivered by ambulance to the
patient's home on the request of a midwife. The number of midwives qualified to
administer analgesia has steadily increased and, since 1950, all midwives employed by
the Council have been so qualified. Progress in its use has been rapid and its administration,
shown as a percentage of all domiciliary confinements, has risen from 3 per cent.
in 1946 to over 75 per cent. in 1952. A similar increase in the use of gas and air analgesia
has also been effected in confinements attended by hospital district midwives and association
midwives. Analgesia is always offered by the Council's midwives. The cases in which
it is not used are those in which the mother refuses or sends too late in labour, is considered
medically unfit to receive it, or the doctor giving maternity medical services himself
provides the analgesic or anaesthetic. The following table shows the progress made: