forensic medicine Criminal abortion 1.pdf

criminal abortion , forensic medicine

1. Criminal abortion
Dr.Smita Mugatkar
H.O.D. of FMT Dept. SBHMC Aurangabad.

2. Def. Any Abortion
induced in
defiance will
amount to
criminal abortion.
▪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. Precautions taken
by RMP in case of
criminal abortion.
▪It is a MLC, inform to police station.
▪Dr. Should take proper history
regarding manner of abortion attempt
or performed.
▪Consult a colleague.
▪Preliminary particular should be
noted ( professional secracy)
▪If pt. Is serious then arrange for dying
declaration.
▪Death certificate should not issue.

4. Natural abortion
costitutional diseases
Congenital
abnormalities
trauma IUD

5. Different methods
of criminal
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

7. It increase the uterine
contractions.
Given in I / v drip.
Cervical dilation done by
cerviprim gel or
misopriston vag. Tab .

8. Cupping
This is a method of criminal
abortion .
A metal mug is kept over
ignated camphor on
hypogastric region.Mug is
vigorously tired &pulled.
Abortion occurs in 24 hrs.
▪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.

10. ComplicatIon
localinjury & infection
Haemorrhage & shock
Perforation of uterus
Incomplete abortion.

11. Laminaria tent
It is made up of wood
which is hygroscopic In
nature,takes moisture &
swells.Thus dilatation of
cervix occurs,then
evacuation is done

12. Syringing
intravaginallywater,soa
p solution, glycerin,
hypertonic glucose/
salt solution is injected
into intra amniotic
cavity by plastic syringe

13. Skilled method
up to 12 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. Manual Vaccum
Aspiration
( up to 7 wks)

15. Dilatation &
curretage .
( up to 10 wks)

16. Suction &
evacuation
( up to 12 wks)

17. Method of
Second trimester
abortion

18. Medical evidence
of abortion
▪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.
▪** Probable intrauterine age
▪**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.

23. Indications for medical
examination
Abortion due to
homicidal trauma
death during abortion
Tries to conseal preg.
Demands more
compensation.

25. MLA
Sec 312 to 316
3 to 10 yr
imprisonment
Sec .511 if preg. 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.