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case a pregnant woman died from haemorrhage, following traumatic
rupture of the spleen. Labour having just commenced rendered a
diagnosis of internal haemorrhage exceedingly difficult and possibly
resulted in a delay in operative measures being carried out. Two
deaths occurred in persons admitted to hospital for caesarean
section where the size of the pelvis precluded the possibility of the
passage of a viable child. The condition of both before operation
was good and everything at the end of the operation in each case
appeared satisfactory. One of the cases some two hours later
commenced a severe uterine haemorrhage which proved fatal. In
the other case, a few days after the operation a peritoneal abscess
developed. On post-mortem examination this abscess appeared
to have no connection with the uterus which seemed healthy.
One patient was admitted to hospital for concealed ante-partum
haemorrhage, but died of post-natal shock following delivery.
It is a question in cases of this nature, whether the transferring
of a patient from her home to a hospital does not cause too much
harm, and whether treatment carried out in the home would not
save some of these patients. If an emergency outfit, including the
services of a nurse, were available at short notice, the patient would
possibly stand more chance of survival by treatment in the home
than she would following removal. The remaining fatal case was a
woman who, on the tenth day following a normal delivery,
developed pleurisy. She was admitted to hospital and was apparently
doing very well, when on the nineteenth day from confinement,
she died suddenly from pulmonary embolism. The cause of
the earlier pleurisy was presumably embolism.
Investigations into maternal mortality due to pregnancy and
childbirth, as suggested bv the Maternal Mortality Committee of
the Ministry of Health, arc carried out bv the Medical Officer ot
Health.
Puerperal Fever and Pyrexia.
12 notifications were received, 8 being of Puerperal Pyrexia
and 4 of Puerperal Fever. Per 1,000 total births the rates for
these conditions are 6.21 and 3.10, the corresponding figures for the
country as a whole being 8.71 and 3.55.
of the cases of Puerperal Pyrexia, 5 made an uninterrupted
recovery at home. One case was admitted to the Isolation Hospital
as a case of Puerperal Scarlet Fever and the two others to Oldchurch
hospital .All these cases recovered. Two of the casts
followed an instrumental delivery, 5 a normal labour and in one
the baby was born before the arrival of the attendant.
All the eases of Puerperal Fever were admitted to hospital, 3
going to Oldchurch Hospital. 2 cases followed a forceps delivery.