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 Definition
 Classification
 Methods of criminal abortion
 Complications
 Causes of death
 MTP – Indications , rules , Punishment
Premature expulsion of the fetus from
mother’s womb at any time of
pregnancy, before full term of
pregnancy is completed.
 Natural – a) Spontaneous b)Accidental
 Artificial – a)Therapeutic ,b) Criminal
 Natural abortion –any time due to natural
causes (common in 2nd or 3rd month)
 Therapeutic or justifiable abortion –when it
is done in good faith to save the life of
women
 Maternal
 Foetal
 Diet – deficient in calcium, iodine
 Defective fertilization – inherent defect in
sperm or ova
 Criminal abortion – Induced destruction
and expulsion of the fetus (products of
conception) from the womb of mother
unlawfully
1.Using Abortifacient drugs
2.General violence
3.Local violence
1. Drugs acting directly on uterus
a) Ecbolics - Ergot , quinine, lead
b) Emmmenagogues – causes increase in menstrual
flow – savin, borax, oestrogen
2. Irritants of Genito urinary tract
- Produce reflex uterine contraction
- oil of turpentine, cantherides
3. Irritants of GI tracts
- irritation of colon- hyperaemia & contraction of
uterus
- castor/croton oil, Senna, Magnesium Sulphate
 Intentional – kicks, jumping, massage
 Violent exercise – horse riding , cycling
 Cupping – a mug is used to separate placenta
 Accidental – violent shaking the body
 Syringing – enema syringe, Higginson's syringe
 Rupture of membrane
 Dilatation of cervix & curettage
 Abortion stick
 Air insufflation
 GI tract may show evidence of traces of
drugs, erosions or congestion of cervix or
uterus
 Instrumental abortion – injury to cervix,
vagina, uterus. Blood clots or bleeding ,
products of conception or placental tags
 Segments of intestine, mesentery may enter
uterine cavity
 Ragged or irregular tears of small or large
intestine
 Cervical canal may be dilated, mucus plug in
the cervix
 Collection of fluid in peritoneal cavity –
rupture of uterus
 Cervical necrosis
 Laceration, perforation of vagina, cervix
 Vagal inhibition
 Thrombo-phlebitis – injury to vessels
 Air embolism
 Bleeding – hemorrhage & shock
 Perforation of uterus , salpingitis , oophoritis
 Peritonitis
 Septicemia
 Immediate : Vagal inhibition, Air embolism,
Haemorrhage, Fat embolism, Amniotic fluid
embolism
 Delayed death : Pyaemia, Septicemia ,
peritonitis, Renal failure, Pulmonary
embolism
 Therapeutic – when women life is in danger
if pregnancy is continued
 Eugenic – when there is risk of child being
born with serious physical or mental
abnormalities (Measles, small pox, any viral
infection, TORCH, Drugs)
 Humanitarian – pregnancy caused by rape
 Social – failure of contraceptive methods in
married women
 Environmental – poor economic status which
affects mother/child health status
 Who can terminate pregnancy ?
 Place of MTP ?
 Consent
 Duration of pregnancy
 Medico legal aspects
 - Registered Medical Practitioner (MBBS)
- RMO if assisted 25 cases of MTP in a
recognized hospital
- MD, Diploma in OBG
 Place of abortion
- Govt Hospital
- Hospital recognized by Govt
- Private hospital after taking license from
District Health Officer
Consent –
1. Written informed consent from women
2. Minor or mentally ill – guardian
3. If husband requests for abortion?
 Register has to be maintained
 Duration of pregnancy
- if < 12 weeks : single doctor
- > 12 weeks : two doctors must agree that
there is an indication
- In case of emergency ?
 Termination of pregnancy by a person who is
not RMP or in an unrecognized hospital shall
be punished with rigorous imprisonment for a
term which shall not be less than 2 years but
may extend to 7 years.
 Miscarriage without the consent of women –
imprisonment up to 10 years (Sec.313 IPC)

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Abortion &amp; mtp

  • 1.
  • 2.  Definition  Classification  Methods of criminal abortion  Complications  Causes of death  MTP – Indications , rules , Punishment
  • 3. Premature expulsion of the fetus from mother’s womb at any time of pregnancy, before full term of pregnancy is completed.
  • 4.  Natural – a) Spontaneous b)Accidental  Artificial – a)Therapeutic ,b) Criminal  Natural abortion –any time due to natural causes (common in 2nd or 3rd month)  Therapeutic or justifiable abortion –when it is done in good faith to save the life of women
  • 5.  Maternal  Foetal  Diet – deficient in calcium, iodine  Defective fertilization – inherent defect in sperm or ova
  • 6.  Criminal abortion – Induced destruction and expulsion of the fetus (products of conception) from the womb of mother unlawfully
  • 7. 1.Using Abortifacient drugs 2.General violence 3.Local violence
  • 8. 1. Drugs acting directly on uterus a) Ecbolics - Ergot , quinine, lead b) Emmmenagogues – causes increase in menstrual flow – savin, borax, oestrogen 2. Irritants of Genito urinary tract - Produce reflex uterine contraction - oil of turpentine, cantherides 3. Irritants of GI tracts - irritation of colon- hyperaemia & contraction of uterus - castor/croton oil, Senna, Magnesium Sulphate
  • 9.  Intentional – kicks, jumping, massage  Violent exercise – horse riding , cycling  Cupping – a mug is used to separate placenta  Accidental – violent shaking the body
  • 10.  Syringing – enema syringe, Higginson's syringe  Rupture of membrane  Dilatation of cervix & curettage  Abortion stick  Air insufflation
  • 11.
  • 12.
  • 13.  GI tract may show evidence of traces of drugs, erosions or congestion of cervix or uterus  Instrumental abortion – injury to cervix, vagina, uterus. Blood clots or bleeding , products of conception or placental tags  Segments of intestine, mesentery may enter uterine cavity  Ragged or irregular tears of small or large intestine
  • 14.  Cervical canal may be dilated, mucus plug in the cervix  Collection of fluid in peritoneal cavity – rupture of uterus
  • 15.  Cervical necrosis  Laceration, perforation of vagina, cervix  Vagal inhibition  Thrombo-phlebitis – injury to vessels  Air embolism  Bleeding – hemorrhage & shock  Perforation of uterus , salpingitis , oophoritis  Peritonitis  Septicemia
  • 16.
  • 17.  Immediate : Vagal inhibition, Air embolism, Haemorrhage, Fat embolism, Amniotic fluid embolism  Delayed death : Pyaemia, Septicemia , peritonitis, Renal failure, Pulmonary embolism
  • 18.  Therapeutic – when women life is in danger if pregnancy is continued  Eugenic – when there is risk of child being born with serious physical or mental abnormalities (Measles, small pox, any viral infection, TORCH, Drugs)  Humanitarian – pregnancy caused by rape  Social – failure of contraceptive methods in married women  Environmental – poor economic status which affects mother/child health status
  • 19.  Who can terminate pregnancy ?  Place of MTP ?  Consent  Duration of pregnancy  Medico legal aspects
  • 20.  - Registered Medical Practitioner (MBBS) - RMO if assisted 25 cases of MTP in a recognized hospital - MD, Diploma in OBG
  • 21.  Place of abortion - Govt Hospital - Hospital recognized by Govt - Private hospital after taking license from District Health Officer Consent – 1. Written informed consent from women 2. Minor or mentally ill – guardian 3. If husband requests for abortion?
  • 22.  Register has to be maintained  Duration of pregnancy - if < 12 weeks : single doctor - > 12 weeks : two doctors must agree that there is an indication - In case of emergency ?
  • 23.  Termination of pregnancy by a person who is not RMP or in an unrecognized hospital shall be punished with rigorous imprisonment for a term which shall not be less than 2 years but may extend to 7 years.  Miscarriage without the consent of women – imprisonment up to 10 years (Sec.313 IPC)