H.—3l

in fact, in manjr cases is essential, the main difficulty being to persuade the patients to accept it, though beds are usually available. The Obstetrical Society has taken this matter up and is conducting a campaign among its members to call attention to this and to the importance of more efficient investigation and treatment. The opinion is generally expressed that an excessive meat diet is at any rate one of the principal causes of the high incidence of toxasmia in New Zealand. This is to a certain extent supported by statistics. The Government Statistician states that the approximate amount of meat available for local consumption is 244 lb. per head of the population per annum. He, however, points out that in spite of adjustments the margin of error may be considerable. It may, however, be regarded as strong support to the opinion that the excessive meat diet probably has an adverse influence upon the health of pregnant women. The Department, through its medical officers and district nurses, is endeavouring to obtain accurate information upon the incidence of toxaemia among Maoris which is believed to be considerably lower than that among the Europeans, and at the same time to obtain information which may show the influence of diet upon the difference in its incidence in the two races. Cesarean Section. A review of the reports of cases of Cesarean section for 1935 shows that 146 patients out of 24,395 confinements were delivered by this method, giving a rate of 0-59 per thousand compared with 0-53 and 044 for 1934 and 1933 respectively. In the following table the cases have been divided into six groups according to the reason given in the reports for selecting this method of delivery.

Table V.

Group I.—Contracted Pelvis. The 57 operations on account of " contracted pelvis " were upon twenty-two primigragida, eighteen 2 para, twelve 3 para, one 6 para, and four para not stated. The degree of contraction was only given in four cases, and it is probable that many of the others might have advantageously been classed under the more comprehensive heading of " obstructed labour." B—H.8 —H. 31.

57

S Number of , Q „, | Deaths. 1934 " Group. Reason given for Operation. ® . . Cause of Deaths and Notes. I -p 2 S a i a n s o "H 3 ® ā M _ fc I Contracted pelvis 57 2 1 (a) Two para. Second opera- 23 2 tion. " Collapse and heart failure," fourth, day ('b) Primipara. Three days in labour. Thyroidectomy two years previously. " Sudden cardiac collapse," third day II Obstructed labout ..42 1 7 Five para. Twenty-four hours 33 2 in labour, failed forceps : "Acute dilatation of stomach," third day. Of the seven infant deaths two were interlocked twins and two monsters III Placenta preevia 13 - 4 . . 14 Accidental haemorrhage 5 .. 4 . . 4 IV Eclampsia .. 12 1 4 Primipara. No ante - natal 7 care. B.P. 200 Temp. 107° Comatose " last resort " V Pre-eclamptie toxaemia 10 1 1 Also disproportion. Medical 12 1 induction failed. Infant that died was one of twins VI Other conditions — Heart disease . . 3 . . . . One primipara, one 2 para, 3 one 11 para. Anaemia and cardiac 1 .. . • 6 para. disturbance Subsequent to removal 1 ■ ■ .... of carcinomatous ovary Carcinoma left breast 11.. • • .... and spine Pyonephrosis and men- 111 • • .... ingitis _