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34
hospital. Involution appeared normal but the general condition in
spite of blood transfusion deteriorated and she died of puerperal sepsis.
The second case went into labour about term. As there was no advance
a medical practitioner was summoned and delivered a macerated foetus
and soon after delivery the patient died from severe retro-placental
haemorrhage.
One of the other fatalities occurred in a nearby hospital to which the
patient had been admitted in a moribund condition caused by a ruptured
ectopic pregnancy.
Two of the cases were to have been delivered at home, private
practitioners being in attendance. The first patient was admitted to
hospital after delivery by forceps had been unsuccessfully attempted.
Owing to the development of a contraction ring craniotomy and cleidotomy
was necessary, sepsis set in and the patient died five days afterwards.
The other case too developed a contraction ring and was admitted
to hospital after forceps delivery at home had proved unsuccessful. She
died undelivered.
The other four patients were all booked hospital cases of which the
following are particulars.
(1). A primipara who had been treated for toxaemia during pregnancy
was admitted in labour. She developed an A.P.H., with suppression
of urine. Delivery was effected, but the patient succumbed to eclampsia.
(2) This patient was delivered by Caesarian section in 1937, but had a
normal confinement in 1940. At her confinement in hospital all was
normal until ten minutes after the birth of the infant, when she collapsed,
having ruptured the caesarian section scar. (3) This patient died from
P.P.H., which occurred some time after a forceps delivery. (4) This death
occurred from obstetric shock following a P.P.H. due to a retained
placenta.
PUERPERAL INFECTION.
Nine notifications of puerperal pyrexia were received, two relating
to women who were in-patients at London Hospitals. In two instances the
pyrexia occurred in a patient in whom some operative interference had
been required. Two of the local cases were patients in Nursing Homes,
and the remainder were delivered at home. Three patients were removed
under the Council's arrangements to hospitals for treatment while one
was taken over by the staff of the District Nursing Association.
INFANT WELFARE SERVICES.
HOME VISITING BY THE HEALTH VISITORS.
The following table shows the number of visits paid by the health
visitors during the year :
(a) To expectant mothers First visits 997
Total visits 1,588
(b) To children under one year of age First visits 2,649
Total visits 8,057
(c) To children between the ages of one and
five years Total visits 17,81—
In addition visits were paid to 237 cases of measles and 301 cases
of whooping cough in children under 5 years of age.