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examined at the ante-natal clinic her blood pressure was 130/86
with no symptoms suggesting toxæmia; but when she was
examined at hospital six days later she was found to be suffering
from a degree of toxæmia sufficient for her immediate admission
to hospital.
(e) Stillbirths (11 Cases).
Four of these cases occurred in primigravidæ; and in a fifth
the only other pregnancy had terminated in a three months' miscarriage.
This last case (aged 24) was referred to hospital for
further advice at 35 weeks because of slight ante-partum haemorrhage
with a rise in blood pressure to 150/100 and was considered
to have a sufficient degree of toxaemia for admission to hospital.
Of the four primigravidae, one (aged 21 years) developed symptoms
of toxaemia between 30-34 weeks, with albuminuria and a rise
in blood pressure to 140/90, and was referred to her general medical
practitioner who sent her to hospital. The second, aged 34 years,
made only one attendance at the clinic. She failed to keep her
second appointment when disproportion might have been suspected.
She had a long and difficult instrumental delivery, and,
in addition to losing her baby, the mother developed infection
of the lower genital tract and had a long convalescence. The third
case attended the clinic regularly, and as the head was in the pelvis
at the last examination no abnormality was suspected, but when she
was in hospital for her confinement it was discovered under general
anaesthesia that there was some obstruction to delivery and it
seems likely that she will be able to have a living child only by
Caesarean Section. The fourth primigravida made one attendance
at the clinic before booking at hospital and no details are available
as to the cause of the stillbirth.
Of the six multiparae, one was advised to book at hospital
because she developed toxaemia at 34 weeks in her first pregnancy.
Her first pregnancy resulted in a live birth, but this one (5 years
later) of which no details are available, terminated in a full term
stillbirth. The second case was a multipara (1) (previous child
living), in which the baby was already dead when she made her
only attendance at the clinic after 36 weeks amenorrhœa. The
third case was referred to hospital because of a suspicious vaginal
discharge. The result was negative, but she had a stillborn anencephalic
monster. The fourth case was a woman of 38 years
who had had two living children followed by a three months miscarriage
and in this, her fourth pregnancy, she developed slight