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33
Summary
1. It was noted that the following 4 factors occurred with by
far the highest incidence:—
No. of cases
(a) Abnormal, prolonged or assisted delivery
477
(b) Toxaemia 256
(c) Birth anoxia 182
(d) Abdominal or pelvic X-ray 102
2. The higher percentage of children considered to be at risk
this year is attributed mainly to 3 possible reasons:—
(i) "Toxaemia" — The possible inclusion of too many
cases, due to insufficient detail.
(ii) "Jaundice" — Insufficient detail available as to its
nature and severity.
(iii) "Drugs in Pregnancy"—Lack of detail, specific enough
to warrant exclusion from Register.
It is considered that the possibility of a Nation-wide
Standardised Obstetric Hospital Discharge Sheet would eliminate
many doubtful cases. After considerable research into the
comparison of types of these particular Discharge Sheets in
detail (as used in 46 hospitals known to admit Redbridge
Obstetric Cases), several suggested specimen Discharge
Summaries were drawn up, aiming to be as comprehensive, yet
concise, and as clear and as legible as possible.
These have been submitted to the Advisory Committee on
Standardisation of Hospital Records (chaired by Dr. Avery
Jones) and are now under consideration.
The demonstration that such handicaps as deafness,
phenylketonuria and congenital dislocation of the hip can be
detected in the presymptomatic stage, must be followed up by
more and more attention to a true Observation Register. It is
felt now that there are possibly too many criteria influencing
the admission of an infant to the Register, and so insufficient
discrimination results. As a result, the "At Risk" group is
showing signs of inflation, with too many normal children
(viz. only 46 of the 1,255 children on the Register were found
to be abnormal). These criteria, or factors, are shortly to be
reviewed in order to bring into effect a more selective Register
in this area.