Virginity, Pregnancy & Delivery [Forensic Approach}

Medico legal Aspects and verification in Female Domain
i.e.

1. Virginity, Pregnancy and Delivery By-PRASHANT SHARMA BATCH-2010 SUBJECT-F.M.T.

2. Female Reproductive System The organs of reproduction of women are classified as either external or internal. External Generative Organ - The pudenda, commonly designated the vulva, includes all structures visible externally from the pubis to the perineum, that is, the Mons pubis, labia Majora and Minora, clitoris, hymen, vestibule, urethral opening, and various glandular and vascular structures 

3. Figure 1

4. Continued… Mons Pubis- The mons pubis, or mons veneris , is the fat-filled cushion that lies over the symphysis pubis. After puberty, the skin of the mons pubis is covered by curly hair that forms the escutcheon. In women, it is distributed in a triangular area, the base of which is formed by the upper margin of the symphysis . Labia Majora - These structures vary somewhat in appearance, principally according to the amount of fat that is contained within the tissues. The round ligaments terminate at the upper borders. After repeated childbearing, the labia majora are less prominent. They are 7 to 8 cm in length, 2 to 3 cm in width, and 1 to 1.5 cm in thickness, and are somewhat tapered at the lower extremities. In children and nulliparous women , the labia majora usually lie in close apposition, whereas in multiparous women, they may gape widely Labia Minora- The labia minora vary greatly in size and shape. In nulliparous women, they usually are not visible behind the nonseparated labia majora. In multiparas , it is common for the labia minora to project beyond the labia majora,Each labium minus is a thin fold of. The tissues of the labia minora converge superiorly, where each is divided into two lamellae; the lower pair fuse to form the frenulum of the clitoris, and the upper pair merge to form the prepuce. Inferiorly, the labia minora extend to approach the midline as low ridges of tissue that fuse to form the fourchette .

5. Figure 2

6. Continued … Clitoris- The clitoris is the principal female erogenous organ. It is the homologue of the penis and is located near the superior extremity of the vulva. This erectile organ projects downward between the branched extremities of the labia minora . The clitoris is composed of a glans , a corpus, and two crura . Vestibule- The vestibule is an almond-shaped area that is enclosed by the labia minora laterally and extends from the clitoris to the fourchette.In the mature state, the vestibule usually is perforated by six openings: the urethra, the vagina, the two ducts of the Bartholin glands, and, at times, the two ducts of the paraurethral glands, also called the Skene ducts and glands.

7. Figure 3

8. Continued… Vagina- This musculomembranous structure extends from the vulva to the uterus and is interposed anteriorly and posteriorly between the urinary bladder and the rectum. Anteriorly , the vagina is separated from the bladder and urethra by connective tissue, often referred to as the vesicovaginal septum. Posteriorly, between the lower portion of the vagina and the rectum, there are similar tissues that together form the rectovaginal septum. The upper fourth of the vagina is separated from the rectum by the rectouterine pouch, also called the cul-de-sac of Douglas.. Vaginal length varies considerably, but commonly, the anterior and posterior vaginal walls are, respectively, 6 to 8 cm and 7 to 10 cm in length. The upper end of the vaginal vault is subdivided into the anterior, posterior, and two lateral fornices by the uterine cervix. Uterus- The uterus consists of a body and a  cervix.The cervix protrudes into the vagina. The uterus is held in position within the pelvis by condensations of endopelvic fascia, which are called ligaments. These ligaments include the pubocervical , transverse, cervical ligaments and the  uterosacral ligaments. It is covered by a sheet-like fold of peritoneum, the broad ligament.

9. VIRGINITY Virginity is the state of a person who has never engaged in “sexual intercourse”. Its IMPORTANCE in Forensic…

10. Defloration It means loss of VIRGINITY It is usually accompanied by tear of HYMEN layer, as it is torn in first coition. But not always, as it can be found intact in Pregnant women, Prostitutes etc.

11. HYMEN The hymen is a membrane that surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia, and is similar in structure to the vagina. In children, although a common appearance of the hymen is crescent-shaped, many shapes are possible. TYPES OF HYMEN

12. Cause of rupture of hymen…

13. Medico-Legal Aspects The presence of HYMEN is not an absolute proof of Virginity. As it may not be ruptured even after repeated acts of coitus carrying the property of hyper elasticity, which prevents distortion and allows prolong displacement of it. But the hymen is always present in Virgins and very rarely its is congenitally absent PRINCIPAL SIGNS OF VIRGINITY ARE…

14. PREGNANCY

15. Definition… Pregnancy is the fertilization and development of one or more offspring, known as an embryo or fetus, in a woman's uterus. Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period (LNMP).

16. Diagnosis…

17. Pictures… Breast changes as seen during pregnancy. Note the increase in size and darkening of the areola. Melasma  pigment changes to the face due to pregnancy Nausea & Vomiting

18. Continued…[Diagnosis]

19. Fluttering movements! Hegar’s Sign Linea Nigra in a woman at 22 weeks pregnant. Chadwick’s Sign- Increased circulation to the vagina early in pregnancy changes the color from normal light pink to a purple

20. Positive Signs Of Pregnancy (those signs that are definitely confirmed as a pregnancy. ) Palpation of the Entire Fetus Palpation of Fetal Movement X-ray Sonography Tests based on the presence of human chorionic gonadotropin (HCG) in the urine or blood.

21. Pictures…

22. Gestation Period

23. Forensic Importance

24. Continued…

25. Medico-Legal Aspects The Preconception And Prenatal Diagnostic Techniques[Regulation And Prevention Of Misuse] Act,1994[Amended]. Also commonly known as PNDT Act. The Act prohibits determination and disclosure of the sex of fetus .  It also prohibits any advertisements relating to pre-natal determination of sex and prescribes punishment for its contravention.  The person who contravenes the provisions of this Act is punishable with imprisonment and fine.

26. CONTINUED… MEDICAL TERMINATION OF PREGNANCY ACT,1971 ( MTP ACT ) An Act to provide for the termination of certain pregnancies by registered medical practitioners and for matters connected therewith or incidental thereto.

27. Continued … Legitimacy And Paternity “ Legitimacy is the legal state of a person born in lawful marriage. If a person is born during the continuance of a legal marriage, or within 280 days after the dissolution of marriage by divorce or death of the husband, HIS/HER birth is presumed to be legitimate . [Sec112, IEA]” “The child becomes illegitimate or “BASTARD”, if it can be proved that the husband could not possibly be the father of child by suitable producing evidence.”

28. Continued …

29. DELIVERY

30. Definition… Delivery is the culmination of a pregnancy or gestation period with the expulsion of one or more newborn infants from a woman’s uterus. The process of normal human childbirth is categorized in three stages of labor: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta.

31. Signs Of Recent Delivery in living

32. Signs Of Remote Delivery in living

33. Signs Of Recent Delivery in DEAD

34. Signs Of Remote Delivery in DEAD

35. Forensic Importance

36. Medico-Legal Aspects

37. CONTINUED…

38. BIBLIOGRAPHY “ THE ESSENTIALS OF FORENSIC MEDICINE AND TOXICOLOGY” DR K.S. NARAYAN REDDY “Parikh's text book of medical jurisprudence and toxicology ” BY Dr C.K. Parikh Modi's Medical Jurisprudence & Toxicology By Editor: Professor B.V. Subramanyam “Maternal anatomy”, DRUGHEALTH’S BLOG( http://drughealth.wordpress.com/2009/06/11/maternal-anatomy/)

39. THE END