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36
of two years of age, influenza, meningococcal meningitis and tuberculosis
being responsible for one death each. Tuberculosis was responsible for
one of the two fatalities of those aged 3, and for one of those of 4 years
of age.
INFANT MORBIDITY.
Ophthalmia Neonatorum.
Two infants were notified as suffering from ophthalmia neonatorum,
one, a mild case, having been born in a London hospital. The other
child, born locally, was removed to hospital for treatment.
Pemphigus Neonatorum.
No notifications were received during 1943.
MATERNAL MORTALITY.
Nine deaths occurred from or were associated with pregnancy,
giving a maternal mortality rate per thousand live births of 2.57 comprised
of a rate of 1.14 for puerperal sepsis and 1.43 for other puerperal
causes. The maternal mortality rates for each of the years from 1934
were 5.99, 3.46, 4.02, 4.19, 3.64, 2.40, 0.62, 3.18 and 1.50. The average
for the first four war years, 1.92, is about half the average figure of 3.95
of the six pre-war years. Only part of the fall can be put to the credit
of chemo-therapy because although the sepsis rate has fallen from 1.4 to
0.6, there has been a similar fall from 2.5 to 1.2 in those causes of maternal
mortality other than sepsis.
In the case of some of these deaths, the pregnancy was only remotely
related, though perhaps the patient would have survived for longer if
she had not become pregnant. One such case was a woman whose
history of phlebitis preceded her pregnancy; some time after her confinement
she developed thrombo-phlebitis of the veins of the leg which
led to gangrene. Even more remote is the case of a woman whose heart
had for long caused anxiety and who died five days after her delivery.
One patient died in the early stages of pregnancy from a ruptured
ectopic gestation, while another died of pyaemia following a self-induced
miscarriage.
One fatality was due to pulmonary embolism a week after a normal
confinement.
In two cases operative interference was followed by paralytic ileus.
One patient who had had previous deliveries by caesarian section died
four days after her delivery this time by the same means. The other,
after a prolonged first stage of labour succumbed to obstetric shock and
paralytic ileus after delivery.
Two deaths were due to puerperal infection. In the one, a normal
confinement was followed in a very short time by the onset of acute
peritonitis due to the hæmolytic streptococcus. In the other, death
finally occurred from broncho-pneumonia due to staphylococcal septicaemia
following surgical induction necessitated by toxaemia of pregnancy.
Of the patients who were delivered at term, three were confined in
their own homes and five in hospitals or nursing homes.