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64
Caesarian section, induction of labour or difficult forceps deliver}.-.
But in the past, this provision has not included the cases of toxaemia
of pregnancy, and even if the resources of the Acton Hospital
could enable it to cope with this class of patient, it is doubtful if
the patients could not be better accommodated at the Central
Middlesex County Hospital. There is no doubt as to the necessity
of providing for all cases of toxaemia of pregnancy in an institution.
It is rarely possible in a working class home to secure the rest,
the rigid adherence to restrictions in diet or other treatment required.
The disastrous results of an attempt to treat such patients
at home were evident in many of the deaths investigated by the
Departmental Committee.
There are other conditions which require institutional treatment,
and with this object in view negotiations are being pursued
with the iliddlesex County Council.
During the year 209 cases were admitted under the agreement
with the County Council to the Central Middlesex County
Hospital.
Puerperal Sepsis.
The Council has an agreement with Queen Charlotte's Hospital
Committee for the admission of cases of Puerperal Sepsis to
the Isolation Block in Ravenscroft Park and 1 case was admitted
during the year.
Consultant in difficult or complicated cases.
Although this aspect of the work appears to be the easiest
to achieve, in actual working it is the most difficult, as the preventive
aspect of the Committee's work is liable to be jeopardised if the
sendees of a consultant can be easily obtained at the confinement.
The work of the Committee must primarily be preventive in its
character, and the ideal to be attained should be the discovery
of cases which present difficulties at the confinement, during pregnancy
through ante-natal supervision. Emergencies will always
occur at confinements, but our object should be the reduction
of such emergencies to a minimum and the surest way to achieve
such a result should be through an extension of ante-natal supervision,
and we have to consider whether the easy and prompt
sen-ices of a consultant at a confinement would not militate against
the success of our scheme as a whole.
Provision of ancillaries.
Among the ancillary sen-ices which may be provided are the
following:—