MSC IV_Forensic medicine -child offence.pdf

Forensic medicine -child offence

1. Forensic Medicine
Dr. Suchita Rawat (MSc, MPhil, PhD)

2. Unit 4: Special Cases in Forensic Medicine
Sexual offences: Rape, unnatural sexual offences, External and
internal findings in living and dead; Protection of Children Against
Sexual Offences (POCSO) Act, 2012; Infanticide, foeticide; Medico
legal aspects of abortion, Medical Termination of Pregnancy (MTP) Act,
1971; External and internal findings in living and dead mother, fetus
and infants; Estimation of age of the foetus.

3. Abortion
●Legal definition
(S.312, IPC).
(pregnancy lasts 10 lunar
months, 40 weeks or 280 days)
●Medical definition
(28 weeks)
●Difference therapeutic
vs. criminal abortion
●legal aspects of
abortion (S.312-16,
S.511, IPC)

4. Abortion
Clinical classification
Accordingto method
induced
According to time period
•Complete
•Incomplete
•Induced: medical/elective
•Inevitable: vaginal
bleeding/membrane rupture
•Missed
•Recurrent
•Septic
•Spontaneous
•Therapeutic
•Threatened: 20 week before
•Natural
•Artificial
•Early: before 12 weeks
•Late: after 12 weeks

6. METHODS OF PROCURING CRIMINAL ABORTION
Abortifacient drugs Violence Local methods Miscellaneous

7. Abortifacient Drugs
Ecbolics:
uterine
contraction
Emmenagogues
: increases
menstrual flow
Drugs
acting
directly
on the
uterus
(i)
cantharides
(ii) Oil of
pennyroyal
(iii) Oil of
tansy
(iv)
Potassium
permangana
te crystals
Irritants
of the
genitourin
ary tract
i) Emetics –
Tartar
emetic
(ii) Saline
cathartics
[MgSO4]
(iii) Strong
purgatives
Irritants
of the
GIT
(1)
Corrosives
(2)
Irritants
Local
applicatio
n of
irritants (1)Inorganic
irritants
(2) Organic
irritants
Systemic
poisons
This Photoby Unknown Author is licensed
under CC BY-ND

8. EVIDENCE OFCRIMINAL
ABORTION
femalegenitalsexcision
abortionbydrugseffectson
femalegenitals,gitandurinary
tract/instrumentalabortion
features i.e. embolism,
infections,injuries/Abortionby
syringingfeatures Clothes,
Genitalcanal,Fluid,Venous
system
ML ASPECTS OF ABORTION
A.Fabricated Abortion/ B.
Trauma and Abortion
Schedule
B.III of Workmens’ Compensation
Act 1923 [WCA 1923]

9. Intrauterine dead
Stillbirth
Infanticide

10. Features Stillborn fetus Dead-born fetus
1.Definition Fetuswhichisbornafter28weeksof
pregnancyandwhichdidnotbreathorshow
anyothersignsoflife,atanytimeafterbeing
completelyborn
Fetuswhichhasdiedinutero
2.Condition in utero Fetuswasaliveinutero,butdiesduringthe
processofdelivery
Deadinutero
3.Findings Signsofprolongedlabor,likeedema,bleeding
intoscalp,caputsuccedaneum*
andseveremolding**ofheadmaybeseen
Rigormortisatdelivery
Maceration
Spalding'ssign***
Robert'ssign****
Mummification
4.Cause Anoxia,prematurity,birthtraumaortoxemia Congenitalanomaly,ABOandRh
incompatibility

11. ***Theword"macerate"comesfromtheLatin"macero"meaningtosoftenby
soaking(inaliquid).Inthisthetissuesaresoftenafterdeathbysoakingandby
enzymaticdigestion,asoccurswithastillborn.
picture source Aggrawal2016

12. Haase'srule : length
from crown to heel or
rump

13. (InternalFindings)
Determination of signs of live birth for infanticide
Hydrostatictest
Principle:specificgravityoflung
beforerespirationis1040-1050
andbecomes940-950after
respirationwhichislessthanthat
ofwaterandmakestherespired
lungtofloat.
(Wredin'stest):
Absence of
gelatinous
embryonic
connective tissue
which was present
during fetal life and
presence of air in
middle ear is seen
after live birth
Breslau's second life test or stomach bowel test
Meconium : 24 hours

14. PostmortemExamination(ExternalFindings)
Determination of signs of live birth for infanticide
Picture source : Google image
Vernix caseosa
Colour of skin Time since
birth
Bright red Just born
Darker 2-3 days
Brick red to yellow to
normal
1 week

15. Changesinumbilicalcord:Thepresenceofmarksof
crushingbyarteryforceps,clean-cutmarginsand
ligature—suggestiveoflivebirth.
Determination of signs of live birth for infanticide
Changes observed in Umbilical cord Time since
birth
Drying up of cut margin 2hours
Drying up of cord 1 day
Inflammatory line at the base of stump 2 days
Obliteration and mummification changes 3 days
Detach (falls off) 5-6 days
Complete healing (scar) 10-12 days
Picture source : Google image

17. Suggestedreadings:
Aggrawal,A.(2016).ForensicMedicineandToxicologyforMBBS.AvichalPublicationCompany,325

18. This Photoby Unknown Author is licensed under CC BY-SA