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54
operation, the case was fatal. This condition, known
as ruptured ectopic gestation, is well known to medical
science and is due to the pregnancy occurring in the
female tubes and not in the uterus or womb. The
progress of pregnancy in such an unusual position leads
to the distension of the tube with resultant distension
and final perforation, which is shown by acute sudden
internal hæmorrhage. The conclusions of such a condition
need no further explanation.
The other two cases were definitely maternal deaths.
The first being one, which although having attended
regularly at the Clinics had in the later stages developed
some toxic signs and although the confinement was
satisfactory as was the subsequent health for about a
month after the confinement, the patient developed
pneumonia which lead to complications and death.
In the second of these two cases the patient had
attended a clinic on five occasions and toxic signs were
found. Recommendations were made and the patient
admitted to hospital for treatment, and after a difficult
labour and a prolonged illness the patient succumbed
to heart failure.
It must be pointed out that both of the latter cases
were under the care of your Consultant Obstetrician
and Gynaecologist.
Finally, it must be borne in mind that over one
thousand pregnancies were terminated satisfactorily in
Barking during the year, and the above three cases
would appear to be those in which no recommendations
could be made to you whereby provision for reducing
the mortality in this small number could be effected.
Mr. J. V. O'Sullivan continues as your Consultant
Gynaecologist and Obstetrician and advises in all cases
of difficulty.