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105
EXPECTANT MOTHERS—MASS MINIATURE RADIOGRAPHY
In 1953 the incidence of active tuberculosis among expectant mothers
in the Area served by Mass Radiography Unit 6.B was 1.38 per 1,000
examined. Although that figure appears to be comparatively low, the disease
has such an important bearing on the health of both mother and child
that any time devoted to its detection among expectant mothers is considered
to be time well spent, and I felt justified in inaugurating in this Area a
scheme whereby X-ray examination of expectant mothers can be held at
intervals sufficiently frequent to enable each expectant mother to be X-rayed
within the first three months of pregnancy.
Inauguration of Scheme.
The number of cases in Leyton is so small that it does not justify
special visits to Clinics by a Mass Radiography Unit; but in October, 1954
I was able to arrange with the Medical Director of the Unit and with the
Medical Officer of Health, West Ham for expectant mothers from Leyton to
attend for Mass Radiography at an Ante-natal Clinic in West Ham when the
Radiography Unit is operating there.
Procedure.
It is necessary for the purpose of the X-ray to be explained to the
expectant mother by the Clinic Medical Officer, Health Visitor or Midwife.
It is made clear to the mother that the X-ray examination is a routine chest
examination to exclude the possibility of tuberculosis of the lungs, and not
an abdominal examination to ascertain the state of the pregnancy. Care is
taken to impress on the mother that she is being referred as a routine precaution,
and not because she is in any way ill.
The expectant mother is referred for X-ray examination preferably
before the end of the third month of pregnancy, and certainly not later than
the end of the sixth month. Should there be any special reason to justify an
X-ray examination after the end of the sixth month, the mother will be
referred for such examination to the Chest Clinic. This is done because
mass radiography films of expectant mothers are difficult to interpret and
assess when the mother has been pregnant for more than six months.
It is found that about 10 per cent. of mothers are recalled for a large
X-ray film to be taken—generally about a week after the first examination.
In the event of any pathological findings, the Unit Medical Director
sends a letter to the mother's doctor suggesting that the mother should be
referred to the Chest Clinic. A copy of this letter is sent to the Area Medical
Officer. The Unit follow up the case later and, in the event of the mother
having failed to attend the Chest Clinic, the Area Medical Officer is notified.
Child Welfare Clinics.
On page 108 will be found a Table giving detailed information regarding
the attendances of infants and children at the Child Welfare Clinics during
the last three years.
It is interesting to record that, although there has been a 7 per cent.
decrease in the number of children eligible to attend the Child Welfare
Clinics during 1954, as compared with the previous year, the attendances
show an increase of 8.6 per cent. over the attendances in 1953. This may be