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From the facts set out in Table No. II. it is a matter for grave
consideration that in spite of antenatal supervision the ''toxaemias
of pregnancy" play a very considerable part in maintaining
the persistently high maternal mortality rate. The amount of
antenatal supervision varies in the four cases quoted above, and
in one case the patient herself failed to carry out instructions.
Case No. 6 is an example of one which is frequently met with in
antenatal work, and which is necessarily a source of great anxiety
to those responsible for the welfare of the patient; this particular
case was apparently of the fulminating type, with a sudden "flare"
of toxic symptoms in spite of treatment. But if antenatal work
is to bring about a reduction in the maternal mortality rate, there
must be more beds available for the reception and treatment,
under continuous and skilled observation, of the many cases that
arise in Clinics of persistent slight albuminuria with raised blood
pressure.
Investigation of maternal deaths is undertaken by the Senior
Assistant Medical Officer (Maternity and Child Welfare), who
collects the details relative to each case from those who were in
attendance on the patient during her pregnancy, labour or immediately
prior to death.
Particulars of all cases notified as suffering from Puerperal
Fever or Puerperal Pyrexia are obtained in detail by the Health
Visitors, whose duty it is to visit each case weekly till the condition
is satisfactory. Hospital facilities are available, beds being
reserved at the Plaistow Fever Hospital and at Whipps Cross
Hospital for the reception and treatment of such cases. Specialist
advice can be obtained on notification to the Medical Officer of
Health by the doctor in charge of the case, the Council having
arranged for the services, when required, of a rota of three
obstetric surgeons. Similarly, an arrangement is in force
whereby any bacteriological examination may be obtained if required
by the doctor for the diagnosis and treatment of the case.
Home nursing of cases of puerperal fever and pyrexia is
undertaken by the Nurses from the several district Nursing Associations
working in the Borough.
INFANTILE MORTALITY.
The infantile mortality rate for 1981 is 62.6 per 1,000 births,
a decrease of .3 compared with that rate in 1930. For the great
towns this rate is 71.0, and for England and Wales 66.0 per
1,000 births.
I he total number of deaths under one year of age in 1931 was
330, of which 194 occurred in male infants and 136 in female infants.
Of the total number of deaths at this age period, 313 were
amongst legitimate infants, and the remaining 17 illegitimate.
Rate per 1,000 births: Legitimate, 60.8; Illegitimate, 138.1.
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