H.—3l.

Table I sets out the number of cases admitted to, work undertaken by, and the puerperal and maternal mortality figures of these hospitals, also the maternal mortality-rate of all cases admitted elsewhere, after correcting the statistics by the exclusion of abortion and ectopic gestation which are not admitted to maternity hospitals. I must explain that the deaths entered under the heading " maternal mortality " are deaths of pregnant or parturient women dying from non-puerperal causes. The cases entered under this heading include two cases of advanced phthisis, three cases of old-standing heart-disease, one ruptured aorta, and one haemorrhage from a gastric ulcer. It is probable that the detection of some of these conditions early in pregnancy might have prevented some of these deaths. This emphasizes the necessity for skilled ante-natal care and prompt treatment. The death-rate for the mixed hospitals is approximately half what it was prior to the restrictions imposed regarding the admission of septic surgical cases in 1930. It is, however, above the average for other hospitals. The statistical returns confirm my opinion that the majority of maternity hospitals are conducted in a satisfactory manner, are well equipped, and are playing an important part in promoting maternal welfare. The outstanding need in regard to all public maternity hospitals is more extensive, more systematic, and a higher quality of ante-natal care, particularly with regard to closer supervision by well qualified obstetricians. The importance of maintaining a high standard of efficiency in our maternity hospitals is shown by the fact that 18,291 out of 27,431 confinements were conducted in them.

ST. HELENS HOSPITALS. Internal Department

Table II. —St. Helens Hospitals, General Statistics, 1931.

38

pC| £3 rA o -f§ •g | fl - ® 'ep 1 -e J 13 I — a 1 1 J ! I I To " J ' is! I j I 1 I i i if| A.—Intern Departments. Total deliveries .. .. .. 572 325 179 206 239 195 546 2,262 Primiparee .. .. .. 202 101 36 48 44 50 169 650 Multiparas .. .. .. 370 224 143 158 195 145 377 1,612 Presentations — Vertex .. .. .. 547 308 162 191 234 183 513 2,138 94-52 Occipito posterior .. .. 6 7 11 10 2 9 21 66 2-92 Face .. .. •• 3 3 2 7 0-31 Brow .. .. . • 2 .. .. .. .. 1 .. 3 0-13 Breech .. .. .. 23 10 5 4 9 3 9 63 2-79 Transverse .. .. .. 1 ■■ •• 2 .. .. .. 3 0-13 Twins .. .. .. .. 8 31331 4 23 1-01 Complications of pregnancy— Hyperemesis .. .. .. .. •• 2.. .. 2 4 0-18 Hydramnios .. .. .. .. 6 8 7.. 3 1 25 1-11 Pre-eclamptic toxaemia .. .. 22 .. 3 24 49 2-17 Eclampsia .. .. .. 1 4 5 0-22 Nephritic toxaemia .. .. 1 1613 1 13 0-57 Hemorrhages — Unavoidable .. .. .. 4 3 1 1 1 1 1 12 0-53 Accidental, external .. .. 4 .. 1 2.. 3 1 10 0-44 Accidental, internal .. .. .. 1 2 .. 3 0-13 Post-partum, atonic . . .. 9 2 1 3 1 2 14 32 1-41 Lacerations of genital tract — Perinaeum .. .. .. 156 32 4 8 19 24 118 361 15-96 Cervix .. .. .. 10 .. .. 1 .. .. .. 11 0-49 Uterus .. .. • • ■ • • ■ Contracted pelvis, inlet . . . . 16 .. .. 2 .. .. 6 24 1-06 Contracted pelvis, outlet .. .. 3 2.. 1 4 2 .. 12 0-53 Prolapse of cord .. .. .. 2 2 .. ..... .. .. 4 0-18 Complications of puerperium— Sepsis, local .. .. .. 4 .. .... 3 1 .. 8 0-35 Sepsis, general .. . . 2 .. .. 2 0-09 Pulmonary embolism .. . . 1 .. .. 1 0-04 Insanity .. .. .. ■ .. • • 1 1 0-04 Crural phlegmasia, venous .. .. . . 1 1 0-04 Crural phlegmasia, lymphatic .. .. .. 1 1 0-04 Mastitis .. .. .. 2 .. .... 1 3 3 9 0-40