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37
INFANT MORBIDITY.
Ophthalmia Neonatorum.
Three notifications of ophthalmia neonatorum were received amongst
infants born in this district. Two of the patients were admitted to
hospital for treatment. All recovered with vision unimpaired.
Pemphigus.
No notifications of pemphigus amongst the new born were received
this year.
MATERNAL MORTALITY.
Four deaths occurred in which pregnancy or childbirth was the
primary cause, one from sepsis and three from other causes. The
maternal mortality rate was therefore 1.02 per 1,000 births compared
with the rate of 1.17 for the country as a whole.
The first fatality was the result of a pulmonary infarction in a
patient who developed an infection after a normal delivery at home,
death occurring nearly a month after the date of confinement. The
second fatality occurred in a patient who had a full ante-natal supervision.
Because of a small pelvis accommodation was reserved for her
at a hospital to which she was admitted before labour because of a
raised blood pressure. As progress in labour was slow delivery was
carried out by Caesarian section. Her condition, however, deteriorated
after operation and she died from eclampsia. The third fatality was
only indirectly related to pregnancy. Haemorrhage from a six weeks'
ectopic pregnancy was followed by peritonitis, probably related to a
previous appendicitis. The last death was the result of pneumonia
and nephritis following a natural abortion of a two months' pregnancy.
The total maternal mortality rate for the country as a whole for
the years 1911 to 1935 ranged from 3.79 to 4.60. The findings of the
Departmental Committee on Maternal Mortality and Morbidity reported
in 1930 and 1932 their findings on an analysis of some 5,000 cases.
These were that 46 per cent. of the deaths showed some primary avoidable
factor. In 15.3 per cent. this was absence or inadequacy of antenatal
supervision ; in 19.1 an error of judgment in the management of
the case ; lack of reasonable facilities in 3.7 ; and negligence on the part
of patients or her friends 7.7.
The rate for the country has fallen since and is now usually well
under two per thousand births. Part of the decline is due to the
reduction in the sepsis rate brought about by the success of the
chemotherapy.
Analysis of the local deaths each year shows that most of them are
not preventable ; that they are of the nature of accidents. To-day in
a district such as this very full advantage is taken of the ante-natal
services available. Those delivered at home have the benefit of the
help of skilled midwives who can summon practitioners, who in turn
can summon consultants or the " flying squad " from Redhill hospital.
Although many more would prefer to be admitted to hospital or other
institutions for the confinement, it does not seem that those whose
needs to be admitted rest primarily on medical grounds are not being