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39
It is noteworthy that 11 of the 29 women in their first pregnancy were
over 30 years of age, the oldest being 39. Of the total of 38 all were in
an excellent state of nutrition except (1) a 34 year old woman who earlier
on had had "vomiting" and phlebitis and latterly dyspepsia; she showed
no signs of hypovitaminosis, (2) the woman aged 29 who had had the miscarriage
and stillbirth. There was one case aged 22 who exhibited probably
a mild degree of riboflavin deficiency—she showed an early angular stomatitis,
a tongue with hvpertrophied papillae, a fine scurfy dermatitis of forehead,
conjunctival and pericorneal injection with fine "streamer" invasion of
the cornea. Otherwise there is little to record.
4 others showed red enlarged fungi form papillae at tip and edges of
tongue, in the distribution more diffuse. Minor caries noted in a few,
for the most part treated. Only 1 case of gingivitis and that of hypertrophic
type. Beyond those mentioned, 10 showed a mild pericorneal injection
and 2 a minor degree of "streamer" formation. In the post-natal group
(total 20), 15—1st pregnancy; 5—2nd pregnancy. Five were not in such
good condition as the remainder, and 4 exhibited pallor, but it was generally
stated that they had never been fat and always pale.
The only case of interest was a very fat woman of 30 exhibiting scurvy
dermatitis of face, enlarged lingual papillae, pericorneal injection and
"streamers."
All 20 women showed some pericorneal injection—fairly well marked
in 8, less marked in 8; 2 other cases showed some "streamers."
Maternal Mortality.—The total number of deaths due to childbirth
during the year was 8, which gives a maternal mortality rate i.e., number
of deaths per 1,000 live births of 3.05 (or 2.97 including stillbirths).
The causes of death were as follows:—Puerperal Sepsis.—(1) Died at
Stepney, E .1; general peritonitis due to an instrumental abortion; conviction
of manslaughter. (2) Confined at and died in Oldchurch Hospital, Romford;
puerperal septic infection, post partum haemorrhage. Other Puerperal
Causes.—(1) Died at Leyton, E.; Shock from instrumental abortion; conviction
of murder, but reduced to manslaughter and using instrument to
procure miscarriage. (2) Confined at and died at Woodside Nursing Home,
Woodford; Obstetric shock, prolapsed uterus. (3) Confined at and died
in London Hospital, E.l; Pulmonary embolism due to thrombosis of the
uterine veins following Caesarian section for toxaemia of pregnancy. (4)
Confined at and died in own home; Cardiac failure; post-partum haermorrhage.
(5) Confined at and died in Victoria Hospital. Romford; Eclampsia, albuminuria
of pregnancy. (6) Confined at and died in Queen Mary's Hospital,
Stratford, E.15; Toxaemia of pregnancy.
MATERNITY HOME.
During 1943, 601 women were admitted into the Home (70 direct to the
Emergency Block and 531 to the Ward Blocks). 679 cases could not be
admitted during the year and other arrangements were made for their
confinement.
At the end of the year 401 eases had booked for future admission to
the Home.
The average number of patients in the Home per dav during 1943 was
26.9 and the average length of stay of patients was 16.3 days.
Emergency Block.—111 cases were treated, 70 being admitted direct
to this Block and 41 being transferred from the Ward Blocks.
37 of these 70 cases had not been booked for admission to the Maternity
Home.
6 of the 70 patients were admitted direct to the Emergency Block for
ante-natal treatment and were subsequently transferred to or re-admitted
to the Ward Blocks for confinement.
The average number of patients in the Emergency Block per day during
1943 was 4.5 (including cases transferred from the Ward Blocks) and the
average length of stay of patients admitted direct to this Block was 15.9 days.