PREGNANCY Medico legal aspects Medicolegal importance 1 2

PREGNANCY Medico legal aspects

Medico-legal importance: 1. 2. 3. 4. 5. In cases of rape. When a woman is committed to death In cases of divorce widow may allege to be pregnant Married women living apart from their husbands

Diagnosis of pregnancy Probable signs of pregnancy: § Breast signs § Abdominal wall signs § Vulva signs § Vaginal signs § Uterine signs

bre ast l m o d Uterine ab vag inal lva u v a in

Sure signs of pregnancy: 1. Inspection of fetal movements after the 4 th month. 2. Palpation of fetal parts after the 4 -month. 3. Auscultation of the fetal heart beats between the 4 th and 5 th month.

: Size of the uterus 1. 2. 3. § § small orange large orange size of fetal head umbilicus at the end of the 6 th month reaching the xiphoid at the end 9 th M

4 - Radiography of the fetus after the 5 th month 5 - Ultra-sonography 6 -The immunological test

Estimation of gestational period in livings: palpating the level of the fundus sonography.

Estimation of gestational period in dead Hess formula length Before the 5 th month = (month) 2 After 5 th month = month x 5

2 - DELIVERY § Medico-legal importance of delivery 1. when a widow alleges that she gave birth to an infant 2. when a murdered newly born infant is found 3. Interchange of infants

Signs of recent delivery 1. General signs exhaustion 2. Breasts 3. Abdominal wall: 4. External genitals: 5. Lochia of

6 -External cervical os: 7 -Ovaries: 8 - Uterus a) b) c) d) Immediately after delivery One week after delivery Two weeks after delivery Six weeks after delivery

Five Day Post-partum Uterus

Signs of remote delivery in living § Breasts: . § Abdominal wall: Lax abdominal wall with linea albicantes. § Perineum: Scars of old perineal tears. § Vagina: Smooth, dilated § Cervix: External cervical os is transverse (slitshaped)

ABORTION § Definition § ML conditions in which a female is examined for sings of abortion 1. After a blow in a fight 2. Medical man gave abortifacient drugs 3. conceal abortion after being charged with it

Types of abortion 1 -Spontaneous abortion § Diseases of the mother § Diseases of the fetus

2 -Induced abortion: A) Therapeutic (lawful) abortion Precautions before performance of therapeutic abortion

Methods A) D&C B) Suction aspiration: C) hysterotomy

B) Criminal (unlawful) abortion

Methods of induction of criminal abortion 1. General violence 2. Local violence 3. Abortifacient drugs

Dangers of abortion 1 - Neurogenic shock 2 - Hemorrhage: 3 - Embolism: a) Air embolism: passage of air opened placental sinuses. b) Soap or glycerin embolisms. c) Thrombo-embolism:

4 - Acute poisoning. 5 - Sepsis.

DIAGNOSIS OF ABORTION § § § Patient ’s consent Signs of pregnancy Signs of general violence Signs of local violence Laboratory investigations Products of abortion

Egg Zygote-implantation Embryo Fetus Viability Birth Subject-of-a-life Person