View report page

109
very deaf and lethargic—given routine treatment for hyperemesis
gravidarum—little change in condition for five weeks—vomited
small amounts twice daily—jaundice cleared—no increase in
dehydration—persistent mild albuminuria—B.P. never above
130/70—examination of optic discs ten days before death showed
blurring of edges but no retinal haemorrhages—later, marked
papilledema with some retinal haemorrhages, slight nystagmus,
speech slurred, no reflexes, vomiting projectile. Patient became
comatose and died at 20 weeks pregnancy. Post mortem examination
revealed toxaemia of pregnancy only.
2. Primigravida, aged 44—home circumstances good—under
care of private medical practitioner for last two months of pregnancy—said
to be " frail " but showed no abnormality during
pregnancy—commenced labour in nursing home—two weeks overdue—according
to hospital report, transferred to hospital after
almost five days in labour—onset of labour had been slow with
early rupture of membranes—later pains became severe for a
day and a half, subsided, and returned early on day of admission—
foetal movements not felt for 48 hours. On examination—toxic
appearance—furred tongue—T. 99.5 deg. P. 156—B.P. 130/85—
urine, ¼ volume albumen—vomited thick black fluid like altered
blood—large baby (R.O.P.) head deeply engaged—os fully dilated
liquor foul smelling—tense tender uterus with well-marked distension
of lower segment—given omnopon and scopolamine—slept
5½ hours—no improvement—pulse irregular—general condition
very poor—manual rotation—mid forceps delivery under gas and
oxygen—macerated stillborn foetus 10½ lbs.—promontory felt at
4½ inches, outlet small—patient moribund at termination of
delivery.
MIDWIVES' ACT, 1936.
Council's Scheme foe Domiciliary Midwifery.
A full report of the arrangements made by the Council in
accordance with the above Act appeared in my Annual Report
for the year 1937. The following figures show in tabular form
particulars regarding the work done during the year 1938. One
of the Council's Municipal Midwives resigned in August, 1938,
and another appointment was made. The new Midwife commenced
duties on 10th October. During the intervening period
arrangements were made with the Essex County Nursing Association
to provide a temporary Midwife.