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75
THE THIRD ANNUAL REPORT
on the
WILLESDEN MATERNITY HOSPITAL.
REPORT ON THE WORK FROM 1st JANUARY, 1933,
to 31st DECEMBER, 1933,
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 1933.
The close co-operation between the Hospital and the Health Centres has been maintained
and the ante-natal supervision of the booked cases continues to be efficiently carried out.
The extension of the hospital which, it is hoped, will shortly be in hand, will do away with
certain disadvantages in the present accommodation. Not the least of these disadvantages is the
distribution of the beds between two large wards. By careful attention to detail, there has been no
medical reason for closing a ward during the past three years, but the necessity for redecorating
during last summer entailed a reduction in the number of cases booked for the period during which
the work was in progress. This is partly responsible for the drop in the number of cases admitted
during the year. When the new wards are in operation it should be possible for cleaning and
decorating to take place without interfering with bookings.
In November, the first batch of pupil midwives entered for the examination of the Central
Midwives Board. Three candidates were sent up and all were successful.
During the year, 493 cases were discharged and one died. The death occurred in a patient
admitted urgently at the request of a Willesden doctor. After admission, it was found that the
patient was resident in the Wembley area and should not have been admitted to this hospital. At
no time could the question of transferring her be entertained. The patient was suffering from
Ante-partum Haemorrhage of the type known as Accidental Haemorrhage. On admission her
condition was desperate but delivery was successfully accomplished. After a blood transfusion,
there was every reason to hope that she would recover but the toxaemia which had caused the
haemorrhage had so damaged the kidneys that they ceased to function. During the eleven days
following delivery before her death, every possible line of treatment was carried out to induce the
kidneys to act, but without success. In the present state of our knowledge nothing further could
have been done either before the onset of the complication or after to save this woman.
The statistical data is presented in the same form as before, and the figures for the two
previous years can be compared with the year under review. Of particular interest is the number of
infant deaths. Only one baby died out of the 476 born alive. This was a feeble premature child
which died shortly after delivery. This result is remarkable when compared with the satisfactory
figure of ten deaths for the previous year. Credit for this belongs to the nursing staff.
Eleven cases of Ante-partum Haemorrhage occurred against five for the preceding year.
All were safely delivered and progressed satisfactorily except for the emergency case reported
above. Properly managed in a well equipped hospital, a case of Ante-partum Haemorrhage can
usually be delivered with little anxiety, although in a private house such cases are recognised as
being amongst the most serious of all obstetric emergencies.
One case was transferred to the Middlesex Hospital early in pregnancy on the advice of
Dr. Evan Bedford. The patient was suffering from pernicious anaemia and an obscure heart
condition.
Twenty-eight cases of Toxaemia of Pregnancy were admitted for treatment and, as before,
all were safely delivered. No case of Eclampsia developed in this series but one patient developed
Post-partum Eclampsia without previous warning. The new ante-natal ward will be a great boon
for the treatment of these undelivered women who now have to be admitted to a lying-in ward.
Twelve emergency cases were admitted from doctors, some of which were admitted very
soon after the complication had occurred. The results of treatment were correspondingly satisfactory.