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practitioner who was called in had difficulty in persuading the patient and
her husband that immediate hospital treatment was essential. One stillbirth
followed a placenta prævia in a woman of 42 years—seventh pregnancy.
Another, which occurred near the end of the child-bearing period, was in a
woman of 42 years—twelfth pregnancy. One stillbirth occurred in a woman
aged 34 who had had three live births followed by four self-induced abortions.
The remaining four stillbirths occurred in primigravidæ, two of whom
were over 30 and had been married nine years before becoming pregnant.
In only one was there an obvious cause for the stillbirth and this was a case
of acute hydramnios which developed in a woman aged 21 years. All
four were delivered in hospital.
(e) Breech Presentation (2 Cases).
Both cases of breech delivery occurred in multigravidse. One made one
attendance only at the ante-natal clinic when she was 20 weeks pregnant.
The second attended regularly. This woman appeared to be malnourished
—poor masculature, and very little subcutaneous tissue—but her condition
was apparently not due to lack of means. Her husband had been in
regular employment and she stated that she had always been able to have
any food she wanted.
(/) Prematurity (10 Cases).
Of the ten cases of premature birth, five occurred in primigravidæ
and five in multigravidæ
Of the primigravidse, none occurred before the 36th week, and in one
only was any abnormality found—a blood pressure above average but with
no other signs or symptoms. All five babies survived.
Of the five multigravidse, one was suffering from attacks of gall stone
colic. The pregnancy terminated at 36 weeks in the birth of a living
child. One had a raised blood pressure for six weeks before the pregnancy
terminated, and showed evidence of albuminuria three weeks before labour,
when she was referred to her private practitioner. The baby survived.
In a third case the woman was so inaccurate over her dates that there
was some doubt as to whether the pregnancy was 38 weeks. Her only
physical abnormality was a mouth full of septic teeth. The fourth case
followed an ante-partum hæmorrhage at 24 weeks in a woman of 39 years
who had had three living children and one miscarriage. Her most obvious
abnormality was in her mouth—the majority of the molar teeth consisted
of septic roots. The fifth case was in a woman of 21 years whose first
pregnancy terminated at 26 weeks, the baby living one hour. This pregnancy
terminated at 36 weeks and the baby lived 5 hours. In the first
pregnancy the premature birth was thought to be due to a fall, and in the
second to a fright. Neither seems a sufficient reason; or if it is allowed
that the fright (which was due to a thunderstorm) might have induced
labour at 36 weeks, it hardly explains why the baby's vitality was so poor
that it lived only 5 hours. The woman's pelvis is generally contracted.
She will be visited so that she may be under supervision if she becomes
pregnant again.
(g) Miscarriage (2 Cases).
One miscarriage occurred in a primigravidse (aged 21) nine days after
her first attendance at the clinic, when it was queried if the foetus was dead.