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67
THE SECOND REPORT
on the
WILLESDEN MATERNITY HOSPITAL.
REPORT ON THE WORK FROM 1st JANUARY, 1932,
to 31st DECEMBER, 1932,
By ARNOLD WALKER. M.A., M.B., B.Ch., F.R.C.S., M.C.O.G.
I have the honour to present the Report of the Maternity Hospital for the year 1932.
The arrangements outlined in the last report have been continued and the working of the
hospital has been carried out in close co-operation with the Health Centres. It is to be hoped that
the financial situation will permit the Council to consider the addition of further accommodation.
The Hospital has been recognised by the Central Midwives Board as a training school for midwives
During the year, 558 patients were discharged and two died. Of these two deaths, the first
was a booked case which died as a result of failure of the kidney function after the onset of labour.
The patient, in spite of repeated requests, failed to attend the antenatal clinics with regularity and,
although a post-mortem examination disclosed old-standing kidney disease of several years duration,
it is possible that the fatal ending might have been avoided by active co-operation on the part of the
patient. The second case was admitted late in labour, seriously ill. She had made arrangements
for her confinement to take place in her own home and I was called in by a doctor under the Difficult
Labour Scheme. She died from Acute Yellow Atrophy of the Liver, a rare form of Toxaemia of
Pregnancy which is almost invariably fatal.
The statistical data in this report is based on the number of cases completed during the year
and not on admissions. This is in accordance with the unified system under which all maternity
hospitals in this country now issue their reports. Of particular interest in the following figures are
those relating to Puerperal Pyrexia, Toxaemia of Pregnancy and Post-partum Haemorrhage. Out
of 560 cases, only two cases of uterine infection occurred, both mild ; no less than 32 of these women
developed toxaemia of pregnancy but the disease was diagnosed promptly in the ante-natal clinics
and treated actively in hospital with the result that again no case of eclampsia is reported ; only one
case of post-partum haemorrhage occurred. Puerperal sepsis, eclampsia and post-partum haemorrhage
are probably the most important of all causes of maternal deaths and these figures go to show the
extent to which these complications may be avoided by the practice of good midwifery.
The number of emergency cases admitted has increased and it is to be hoped that as time goes on,
more and more of the abnormal cases which occur in Willesden will be admitted to the hospital.
A considerable number of these cases reach the ante-natal clinics and are admitted on medical grounds.
This section forms a proportion of the cases booked by every maternity hospital. The patients
differ as a class from the true emergency admissions in that the medical staff of the hospital have had
the opportunity of treating an intercurrent disease or preparing for difficulties likely to arise during
labour. In the true emergency cases, the hospital staff are called upon to deal with complications
which have already arisen and over which they have had no control. It is by the early diagnosis
and early hospitalisation of the abnormal case that maternal mortality and morbidity will be reduced.