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Analysis of Abnormal Cases.
(Report by Dr. Menzies).
(a) Instrumental Delivery (16 Cases).
Of the instrumental deliveries, 14 occurred in primigravidas. Of these,
six had arranged to enter hospital for their confinements. The remaining
eight had booked with midwives.
One was sent to hospital for advice as a possible disproportion. In
two cases it was noticed that the head was not fixed at the thirty-eighth
week, but no definite disproportion was found. A third developed mild
pre-eclampsia at the thirty-sixth week, and labour occurred at the thirtyninth
week, resulting in the birth of a living child weighing lbs. The
only case which resulted in a stillbirth was a woman aged 34 who failed
to attend the clinic after the thirty-sixth week, and may have been one
week overdue when she was sent into hospital as an emergency by her
private medical practitioner. The ages of these 14 primigravidæ ranged
from 22 to 36 years. Five were under 25 years, and six were over 30 years.
As a separate investigation shows that 52 per cent, of the primigravidse
attending the clinics are under 25 years, and only 11 per cent, over 30 years,
this demonstrates the truth of the assumption that the risk of instrumental
delivery in a first confinement increases markedly as the woman's age
reaches 30 years and over.