Monthly Obstetric Meetings

SINCE 1946 a meeting has been held monthly in the Royal Maternity Hospital, Belfast, during the months September to June. It has been attended by the staff of both maternity hospitals and by representatives from the Department of Pathology, the Ministry of Health, and the City Borough Healthi Department. At this meeting the monthly statistical reports for the Jubilee Maternity Hospital and the Royal Maternity Hospital have been presented and discussed. Maternal and foetal mortality have been reviewed-an obstetric or paediatric paper has been read and followed by a general discussion. A meeting was held on Wednesday, 18th January, Mr. T. S. S. Holmes taking the chair. Dr. A. T. Elder read a paper entitled "Preventive Medicine and the Practice of Obstetrics." He traced the history of preventive medicine in obstetrics, giving a detailed review of the literature and considered that the present favourable position was due to cooperation of obstetricians, bacteriologists, and the public lhealth authorities. Antenatal supervision should be performed by officers with resident obstet'ric experience and a senior consultant should be available at clinics for the examination of difficult cases. Bed spacing in maternity hospitals was of importance and isolation blocks must be available for infected cases. Dust-free ventilation was necessary and staff, patients, and equipment should be subjected to bacteriological control. Infection should be notified promptly to the health authorities, and the speaker emphasised the importance of cooperation in this respect. A meeting was held on Wednesday, 19th February, Mr. T. S. S. Holmes taking the chair. Dr. T. M. Roulston read a paper entitled "Cesarean Section." He reviewed 646 cases of cesarean section performed in the Royal Maternity Hospital, Belfast, in the years 1943-1947. The section rate was 8.9 per cent. This high figure was due to the number of abnormal cases referred to the hospital, the number of repeat sections, and the high incidence of primigravide treated. The indication in 67 per cent. of cases was cephalo-pelvic disproportion, and placenta praevia accounted for 8.5 per cent. Although vaginal delivery following a previous section was achieved now in an increasing number of cases, repeat sections accounted for 32 per cent. of series. Elective sections were performed in 28 per cent. cases, and the remainder (40 per cent.) were performed in patients in labour. The maternal mortality was 1.43 per cent. and the foetal mortality 5.7 per cent. The speaker emphasised that all the deaths occurred …