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toxaemia at 36 weeks, and had a macerated foetus at full term.
The fifth case was a woman of 31 years, whose first pregnancy
terminated in a four months' miscarriage, her second in a stillbirth
at 36 weeks, and this was the third. The foetal heart sounds were
heard at her last attendance when she was thought to be 35 weeks.
Unfortunately she did not keep her next appointment, and although
the pregnancy continued four weeks longer than was expected, her
midwife did not induce her to re-attend. She made no advance
in labour and was sent to hospital. The sixth case was a multipara
(4) of 28 years. The stillbirth was due to a large sacral meningocele
which prevented delivery of the buttocks. A general
anaesthetic was given and the meningocele punctured. The confinement
took place in hospital.
(f) Prematurity (11 Cases).
Of the eleven cases of premature birth, five occurred in primigravidae
and six in multiparae.
The primigravidae ranged from 22 to 36 years. None of the
premature births occurred before the 36th week. In two cases,
only one attendance had been made at the clinic and there was
some doubt as to the accuracy of their dates. The only abnormalities
found antenatally in these five cases was a slight rise in
blood pressure at the 37th week in one case (she had her baby two
days later), and in a second disproportion was suspected at 36
weeks. She was sent to hospital and had her baby two weeks
later following an accidental haemorrhage. The only baby who
did not survive was one who had hydrocephalus.
Of the six multiparae, two made only one attendance late in
pregnancy. A third was found to have albuminuria and raised
blood pressure at her first attendance when she was 24-26 weeks
pregnant, and was referred to her private medical practitioner.
She was sent to hospital and had a premature stillbirth two months
later. She was 39 years of age, and had had six children—all
normal labours. Of the other three, two were in poor financial
circumstances and were allowed free milk. One of the two was
obviously in a poor state of nutrition. Her baby was born at
34 weeks and lived six hours. The third was in poor physical
condition, thin and nervous, and suffered from excessive vomiting.
She had three weeks' rest in a convalescent home during pregnancy.
Her husband was working, but not at a good wage. The baby was
born in hospital, about two weeks premature and did not survive.