View report page

51
by extending officially her range of duties—an extension which will bring
them into line with to-day's practice in many areas. It is particularly
to be regretted that it is becoming increasingly difficult to be able to
appoint such important people.
MORTALITY AMONGST CHILDREN OF 1-5 YEARS OF AGE.
Infections which had started to exert their toll on the older of the
infants under one year of age remained the most important cause of
death in the next few years. Of the 8 deaths of those of one year of age,
5 were due to infections (pneumonia 1, meningitis 2, tuberculous meningitis
1, and measles 1). The 7 deaths of those of two years of age were
mostly due to developmental diseases, or developmental abnormality.
Accidents accounted for 2 of the 5 deaths of those ages three and four.
INFANT MORBIDITY.
Ophthalmia Neonatorum.
Two notifications of ophthalmia neonatorum were received, one in an
infant born in an institution, one at home. One of the patients was
referred to the District Nursing Association for treatment. Both
recovered with vision unimpaired.
Pemphigus.
One notification was received this year of the occurrence of pemphigus
among the new born. The infant was treated in hospital and
recovered.
MATERNAL MORTALITY.
Three deaths occurred in which pregnancy or childbirth was the
primary cause, all three from conditions other than sepsis. The puerperal
mortality rate was therefore 0.74 per 1,000 births, compared with the rate
of 1.43 for the country as a whole. The first fatality was a patient
pregnant for the fifth time, but whose previous pregnancies had resulted in
miscarriages. She was under regular ante-natal supervision and because
of toxaemia was referred to hospital. A Caesarean section was performed,
but she failed to survive the operation. The second case died from a
severe post partum haemorrhage, which was due to hypoplasia of the
uterine muscles, cause unascertainable. The third fatality was of a
patient who died from haemorrhage due to the rupture of an ectopic
gestation. It is difficult in cases such as these to see what could possibly
be done to evade fatalities. It would seem that whatever machinery is set
up, there will be occurrences of this nature which are almost in the
nature of accidents of pregnancy or parturition.
PUERPERAL INFECTION.
Of the 20 notifications received, 9 were in respect of patients delivered
in local nursing homes, the remainder at home. Five followed an
abortion. In 4, the cause seemed to be uterine infections ; 3 were infections
of a perineal tear, while pyelitis was the cause in 2, inflamed
breast 1, phlebitis 1, and other infections such as influenza caused 2.
Removal to an isolation hospital was arranged in 13 instances, and home
nursing provided in 2.