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A brief resume of the investigation of each new case is as
follows:—
Enquiry is made into the past history of the patient and all
illnesses, fevers, or accidents are noted. Questions are asked about
the health during the pregnancy, especially in relation to constipation,
shortness of breath, sickness, evidence of kidney disease, etc.
By this time the ice is broken and information can be obtained
about the social and domestic circumstances of the patient with a
view to possible help in necessitous cases, the advisability of having
the baby at home, etc., etc. This last investigation has perhaps
done as much good and been as much help to the mother as any
other.
The patient is then examined first in regard to her general
condition. This includes an estimate of her build and physique,
examination of the heart, lungs, teeth, and breasts. Any doubts
held on the advisability of breast-feeding are explained at once.
A visit to the patient's dentist or in cases of poverty to the dental
clinic, is urged in the event of decayed teeth. The pelvic measuremens
are taken with a view to ensuring as far as possible that there
is no contraction of the birth canal. If the patient is seen in the
latter months of pregnancy the position and size of the baby is
noted and the prospective mother is reassured on this point. Any
case presenting any abnormality is advised to attend the clinic
regularly.
During the year the routine examination has revealed a number
of early cases of toxaemia of pregnancy. The majority of these
cases have responded to light diet and rest in bed at home. A few
cases have required more energetic treatment and have been referred
either to their own doctor, to the West Middlesex Hospital, and in
one instance to St. Thomas's Hospital. Aid has been sought from
the same sources in the cases of pelvic contraction. In many instances
the position of the baby has been corrected by the external
version of a breech presentation. In two mothers this was not
possible and arrangements were made for them to have the version