Allegedly the Rotunda Hospital, Dublin, Ireland, is the oldest maternity hospital in continuous operation in Europe. For about two centuries it’s walls and it’s hospital personnel have been exposed to an endless parade of human pregnancy pathophysiology and pathology, including the Metabolic Toxemia
of Late Pregnancy (MTLP)-Complex: puerperal convulsions, puerperal fever, toxic abruptio placentae, maternal and fetal and neonatal deaths, intrauterine growth retardation (IUGR)/small- for-gestational-age (SGA), premature labor and birth, low-birth-weight (LBW) infants, molar pregnancies, congenital anomalies, pre-eclampsia, recurrent abruptio placentae.
These and other pregnancy complications caused by maternal malnutrition have been described, recorded by generations of “Masters of the Rotunda,” whose reports I began to study in the early 1970s after publication of my book, METABOLIC TOXEMIA OF LATE PREGNANCY: A Disease of Malnutrition. (Springfield, ILL. USA, C.C. Thomas, Publ. Inc. 1966).
At that time the reports of the physicians, OB/GYN surgeons, pediatricians, pathologists, anesthesiologists, internists, et al., were accompanied by extensive “observations” of the lives and social-economic problems of the Rotunda Hospital patients by people in the Department of Social Work.
Here were descriptions of the desperate poverty of many Dublin women, their abuse by men in their lives, alcoholism, unemployment, unmarried pregnancies, school-girl pregnancies, housing shortages and low incomes, conditions which surely are linked to pregnancy and pre-pregnancy malnutrition, yet at no time did I read in the physicians descriptions of MTLP-complex diseases a single word regarding the nutritional status of a single pregnant patient in an individual clinical medical history.
For several years I tried to interest “The Masters” of the Rotunda in pregnancy malnutrition’s role in the etiology of the MTLP-complex, but I had no success to date, January 8, 1997. The general level of nutrition/malnutrition consciousness among U.K. physicians in OB/GYN, perinatology, maternal-fetal medicine, epidemiology of MTLP-complex problems, is reflected in a classic paper, “CLASP: a randomized trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women.” THE LANCET 1994; 343:619-29, March 12, with editorial comments by the Rotunda’s Profs. Michael Darling, John Higgins, p. 616.
Since this Oxford University/UK Medical Research Council/Bayer-Europe/ European Aspirin Foundation/Sterling Winthrop “large numbers, randomized, pseudoscientific atrocity” failed, turn to the Department of Social Work at the Rotunda Hospital, Dublin 1, Ireland. The answer is there!