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forensic medicine Criminal abortion 1.pdf
- 1. Criminal abortion Dr.Smita Mugatkar H.O.D. of FMT Dept. SBHMC Aurangabad.
- 2. Def.AnyAbortion inducedin defiancewill amountto criminalabortion. ▪It is an unlawful expulsion of product of conception at any stage of gestation by any unqualified person or Dr. Is punishable under law. ▪Sec. 312 to 316 IPC refer to offence of criminal abortion. ▪3to 10 yr. Imprisonment with fine depends on age of foetus.
- 3. Precautionstaken byRMPincaseof criminalabortion. ▪ It is a MLC,inform to police station. ▪ Dr.Should take proper history regarding manner of abortionattempt or performed. ▪ Consult a colleague. ▪ Preliminary particular should be noted ( professional secracy) ▪ If pt.Is serious then arrangefor dying declaration. ▪ Death certificate should not issue.
- 5. Differentmethods ofcriminal abortion. Drugs Directly acting on uterus Ecbolics- increased uterine contractions.eg. Ergote,cotton root bark, synthetic oestrogen,pitutary ex Emmenagogues- increase the menstrual flow.eg. Borax, oil of savin Sanguinarine. Indirectly acting on uterus- emitics , purgatives,lead poison
- 8. Cupping Thisisamethodofcriminal abortion. Ametalmugiskeptover ignatedcamphoron hypogastric region.Mug is vigorously tired&pulled. Abortionoccurs in24hrs. ▪Abortion stick. ▪This is a wooden or bamboo stick, about 20cm long.one end of stick is wrapped up with cloth / cotton & is soaked in juice of marking nut, abrus ,oleander,Paste of arsenic. ▪Stick is passed in uterus per vagina ▪Resulting in rupture of membranes & expulsion of product of conception.
- 11. Laminariatent Itismadeupofwood whichishygroscopic In nature,takesmoisture& swells.Thus dilatationof cervix occurs,then evacuationisdone
- 13. Skilledmethod upto12 wks vaccum aspiration D&C D&E ▪After12 wks to 24 wks ▪Dilatation & oxytocin drip ▪Extraamniotic infusion of ethacrinic lactate ( Emcredil) ▪Amniosynthesis – amniotic fluid replacement therapy. ▪Electricity – used in advanced countries. ▪Abdominal hysterotomy.
- 14. ManualVaccum Aspiration ( upto 7 wks)
- 15. Dilatation & curretage . ( upto 10 wks)
- 18. Medicalevidence ofabortion ▪ Examination of female ▪ General condition exhaust look, increased temperature & pulse. ▪ Heavy enlarged breast ,with dark pigmented areola & nipples . Colostrum may be ooze on squeezing the breast. ▪ Lax & wrinkled abdomen.striae gravidarum & linea nigra may be present. ▪ Laceration ,bruise, Inflammation present at vagina , perineum,labia etc. ▪ Signs of involution of uterus. ▪ Hcg may be detected up to 7 days.
- 20. Examination of aborted material ▪ Presence of chorionic villi on microscopic examination will confirm that it is product of conception. ▪ During first trimester the foetus expels along with the membrane. ▪ 2 nd trimester fetus born first & then placenta expelled. ▪ ** Probableintrauterineage ▪ **presence or absence of injuries on body. ▪ **Viability of child.
- 22. MLA of placenta ▪Period of gestation can be estimated. ▪Some disease or poison may be detected in placenta. ▪Placental barrier may result in fetal death, infection or malformation. ▪Retained placenta may be found in criminal abortion & may be the cause of death due to haemorrhage.
- 25. MLA Sec312 to316 3to10 yr imprisonment Sec.511 ifpreg.Is beyond quickening ▪Has any instrument is used ? ▪Has self induced or assisted? ▪Presence of any injuries in vagina ,cervix,uterus . ▪Injecting fluid may be obtained from inferior vena cava & pulmonary arteries. ▪Time of interference. ▪Vagal inhibition – instantaneous death ,air embolism - few seconds.