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74
THE FOURTH ANNUAL REPORT
on the
WILLESDEN MATERNITY HOSPITAL.
REPORT ON THE WORK FROM 1st JANUARY, 1934,
to 31st DECEMBER, 1934,
By ARNOLD WALKER, M.A., M.B., B.Ch., F.R.C.S., M.C.O.G.
The extension to the hospital was completed by the end of the year, and the new wards were
immediately put into use. Certain alterations had to be carried out in the old buildings after the
new wards had been taken over, and the whole hospital was in full use by the beginning of February,
1935. 3The extension has had the effect of converting what was an inconvenient and unsatisfactory
maternity unit into a well.balanced hospital. Although the actual number of beds has been doubled, it
will not be possible to take in quite the equivalent number of extra patients, because the additional beds
include four isolation rooms and a ward of eight beds for ante.natal cases. This ward might be called
the most important in the hospital, because it is in the management of these cases that maternal
mortality is reduced.
In spite of the inconvenience caused by the presence of the builders, 53 more cases were dealt
with during 1934 than during 1933. Even during the period when the new buildings were being
taken into use and the old handed over to the builders, the normal work went on, and no patient
suffered the least inconvenience. This was entirely due to the excellent arrangements made by the
Matron, and the efficiency with which she organised her staff.
Again no booked patient died, although two deaths occurred in cases admitted as emergencies.
Both patients were seen in their own homes by the Consulting Obstetrician at the request of the
doctors concerned. The first case had suffered from puerperal sepsis following a miscarriage several
years ago. She was in hospital for over a year and, from the records of the hospital concerned, it is
remarkable that she survived. Although the patient was apparently fit to stand a pregnancy, the
possible dangers were well realised by her doctor, and she was under his constant supervision for
months. At the first signs of trouble the doctor asked for help. Within an hour or two the patient
was seen and was admitted to the hospital. Although there was nothing to suggest at the consultation
that the patient was gravely ill, eclamptic fits started in the ambulance and the patient
died a short time after admission. Co.operation between the patient, her doctor and the Council's
service was excellent, but in spite of this the woman lost her life. It is difficult to see what more
could have been done. The second case was admitted after being in labour for several days. She
had been seen privately by a senior obstetrician a short time before term, and passed as normal.
Labour was complicated by uterine inertia, a complication which cannot be prevented or anticipated.
She was eventually delivered in the hospital after a labour of five days, and all went well for three
days. Quite unexpectedly the patient had secondary post.partum haemorrhage, from which she
recovered, only to die suddenly from what appeared to be pulmonary embolism. In this case again
everything was done to ensure a successful result.
The statistical data is again presented in the same form as before, and next year it is proposed
that the combined results of the first five years be tabulated with the results for the year for purposes
of comparison. As the bulk of obstetric cases are classified as normal, conclusions can only be drawn
from large numbers.
Again a considerable number of cases of Toxaemia of Pregnancy were detected at the Antenatal
Clinics, and were all safely delivered. The excellent results which have been obtained in the
treatment of these cases, and in the treatment of Heart Disease show the value of proper ante.natal
care. Many.other cases are admitted for ante.natal treatment, but these two groups are, by far,
the most important. The excellent accommodation for them now is one of the most progressive
features of the new hospital.
The number of cases in which interference was required is smaller, and both the "forceps
rate" and the " Caesarian Section rate " are lower. This is very satisfactory.
Puerperal Pyrexia occurred in nearly twice as many cases as in the previous year. This increase
was entirely due to causes not associated with childbirth and calls for no comment.