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a woman has been reckoned as a primigravida if she has not previously
had a viable child. This gives a higher percentage of
primigravidae than is shown in the analysis of ante-natal records
from 1930-34, which is included elsewhere in this report.
Analysis of Abnormal Cases.
(Report by Dr. Menzies).
(a) Instrumental Delivery (23 Cases).
Of the instrumental deliveries, 18 occurred in primigravidae.
Of these, nine had arranged to enter hospital for their confinements.
The remaining nine had booked with midwives.
Of the midwives cases, two were referred to hospital for further
advice. In one case version was performed ; in the second arrangements
were made for admission to hospital as the presentation was
left occipito-posterior and the promontory was felt at inches.
In two cases the head was not fixed at 38-39 weeks, but no definite
disproportion was found. Three cases did not attend in the last
month of pregnancy although urged to do so by the midwife or
health visitor.
The ages of these 18 primigravidae ranged from 22 to 35 years.
Three were under 25 years, and eight were over 30 years. A
separate analysis of ante-natal records shows that 52 per cent, of
the primigravidae attending the clinics are under 25 years, and
only 11 per cent, over 30 years.
Of the 5 multiparae who had instrumental deliveries, one was
having her second child fifteen years after her first; and a second
was having her fifth child after a nine year interval, the first three
having occurred in four years, and the mother's general musculature
being poor. The third case was in a woman of 46, of poor physique,
who was having her sixth child after a five year interval. The
fourth case was referred to hospital as she had a small pelvis, and
had already had one stillbirth followed by a live birth by instrumental
delivery. The fifth case was unable to attend during the
last six weeks of pregnancy, but it was noted at 34 weeks that the
head was large.
There were no stillbirths among the instrumental deliveries.