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Ultimate prognosis in cases of eclampsia and albuminuria of pregnancy

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SymJCB_1928redux.pdf (9.314Mb)
Date
1928
Author
Sym, Jessie C. B.
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Abstract
 
 
Eclampsia has been recognised for many years as one of the most formidable risks which the childbearing woman has to face. Stroganoff states (Journ. of Obst. and Gyn. Brit. Emp. 1923 xxx p.1.) that out of every 10,000 labours four women die of Eclampsia and that 5600 women die annually of Eclampsia in Europe alone. From the Registrar's Reports for England and Wales, Scotland and Ireland it appears that on an average 600 women die annually in these islands of Eclampsia. Further, since 70% of these women are pregnant for the first time, 400 women die with their first child, the majority, had they lived, would probably have had other children. The foetal mortality is, and, since the disease frequently appears while the child'.. is still premature, must remain, extremely high. Williams (Obstetrics. 5th Edition.p.622) estimates it at 50%, but considers that not more than a third of the children leave Hospital alive as owing to prematurity the neo -natal death rate is also high. At the Royal Maternity Hospital, Edinburgh, 44% of the children of eclamptic mothers left the Hospital alive. Therefore since it attacks mainly the young child bearing woman and the foetus drawing to maturity, Eclampsia, although relatively a rare disease, is of importance to every race in which it occurs. If further, the surviving mothers are incapacitated either partially or totally for further chill-bearing, the increased gravity of the disease is at once apparent. As regards Albuminuria of Pregnancy the position is rather different. Eclampsia is always severe; the severity of Albuminuria varies from a mild Albuminuria in the later weeks of pregnancy to "pre-eclampsia". The prognosis for the Mother under efficient treatment is fairly good but for the foetus, owing to the frequency of premature labour and still birth, it remains poor. Albuminuria during pregnancy is, however, an extremely common condition. It occurs, excluding the physiological Albuminuria of labour, in 3.5% of all pregnant women. (Eden and Holland Manual of Midwifery 6th Edit. p 96 et seq.) If it affects the health of so large a percentage of child-bearing women, it is a serious disease especially if the ill-effects should persist after the pregnancy. If it impaired the ability of these women for the bearing of future healthy, full-time children, it is from the point of view of the race and not of the individual in some respects an even more serious disease than Eclampsia. An attempt has therefore been made to find out whether a woman who has suffered from one of the later toxaemias of pregnancy is damaged either in regard to to her subsequent health or her child-bearing capacity and with this object in view the following investigation has been carried out.
 
URI
http://hdl.handle.net/1842/34158
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  • Edinburgh Medical School thesis and dissertation collection

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