Download MBBS Criminal Abortion Lecture PPT

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Criminal Abortion PowerPoint PPT presentation







Criminal Abortion
Dr. Vinod Kumar,
Prof. & HOD,
Forensic Medicine,
TMMC&RC
2020


















Criminal Abortion
n Any abortion induced in defiance of one or more of the provisions wil
amount to criminal abortion
n In simple words it can be defined as:-
n Abortion which is not as per Termination Law
Motive for Criminal Abortion
1. To get rid of child fol owing il icit intercourse with a view to avoid the shame
and disgrace in cases of:-
Widows
Unmarried girls
Married woman conceiving during long absence of her husband
2. To prevent inconvenient addition to the family






















Methods adopted in inducing Criminal Abortion
Up to the end of 1st month
Mechanical violence used by several means
Extrauterine means:-
Lifting of heavy weight, horse riding, cycling, jolting
Kicks and blows over abdomen, fal ing or jumping from a height
Kneading or firmly massaging the ant. Abdominal wal
Tight compression of lower abdomen, alternate hot and cold
bath, use of purgative
By the end of 2nd month
( Suspicion becomes a surety now:- more drastic measures are adopted )
Use of Abortifacient drugs





























Abortifacient drugs
A) ECBOLICS -- these drugs contracts the pregnant uterus.
a) Ergot preparations, b) Quinine, c) Strychnine, d) Synthetic estrogen,
e) Pituitary extract
But not always successful in low doses, in higher doses- may cause danger
B) EMENAGOGUES ?these durgs initiates and increases menstrual blood flow.
a) Oestrogen, b)Borax, c) Savin, d) Sanguinarine
C) Drugs irritating genito urinary tract? these are
a) Cantherides, b) Oil of pennyroyal, c) oil of tancy, terpentine
D) Drugs which irritates the GI Tract? these reflexly initiates uterine contraction
Emetics- Tartar emetic
Saline cathartics? Magnesium sulphate
Strong purgatives? Castor oil, Croton oil, Aloes, Colocynth, Phenolphthalein




















Abortifacient Drugs ? cont.
E) Drugs which are primarily toxic to other systems
Inorganic irritants? salts of lead, arsenic, phosphorus, copper, mercury, antimony.
Organic irritants? unripe fruit of papaya, pineamethi, Rati ( abrus precatorious)
Calotropis, plumbago:- (juice is used in abortion stick)
F) Patent preparations:- abortion pil s made of lead, diphenylethylene





Organic irritants
Rati ( Abrus Precatorious )
Plant with pods
Seeds




Organic irritants
Unripe fruit of Pappaya
Unripe Pineapple





Organic irritants
Methi ( Fenugreek)
Methi Leaves
Methi Seeds




Organic irritants
Calotropis Gigantea
Calotropis Fruit





Organic irritants
n Plumbago
















General Violence
n G) General Violence-
n Beside the method already discussed under the heading Extra uterine means
n Cupping?
n A flaming light is placed on abdominal wal . It is covered by a bowl--
air expands? on cooling air contracts? bowl sticks to the abdominal wal ?
bowl is pul ed suddenly? causes separation of placenta



Cupping

H) Introduction of Utus Paste --
(containing mercury, thymol, iodine and some other
agents) inside the
uterus leads to abortion.
I) Pushing laminaria tent and abortion stick inside uterus
J) Rupture of membrane by - hair-pin, nail
K) Syringing --Higginson's syringe? Abortifacient fluid
like soap water,
KMNO4 sol., cresol,
Lysol or tincture iodine pushed inside uterus.




















Local violence
n Syringing
n Rupture of membrane
n Abortion stick
n Syringe and aspiration
n Vacuum aspiration
n Dilatation of cervix
n Air insufflation
n Electric current
n Utus paste


Higginson syringe















Higginson syringe
n Soap water
n Dettol water
n Alum
n KMNO4
n Formalin sol.
n Lysol



Abortion Stick


See Weed ( Laminaria)





Laminaria tent
Irritant Plant Twig


Materials used for local violence









Causes of death and dangers of criminal abortion
1) Causes of rapid death:-
Haemorrhage- common in incomplete abortion
Perforation
Vagal shock
Fat embolism- when fat containing solution is used
Air embolism



















Causes of death and dangers of criminal abortion
Delayed death :- ( within some days)
Peritonitis ( in case of perforation)
Local infection
Tetanus
Septicaemia, pyemia
Remote causes:- (Death occurs due to complications of abortion)
Renal failure
Meningitis
Endocarditis
Hepatitis
Toxic effect of abortifacient drugs :- may cause death during any period
























Evidences of criminal abortion
n In living lady
n Signs are akin to those found in recent delivery (modified by certain factors)
n Breast changes (in primipara)
n Enlargement of uterus
n Haemorrhage
n Offensive vaginal discharge
n Vaginal speculum examination:-
n Vaginal erosion/ laceration
n Cervix- Softening / lacerations
n Signs of peritonitis






















Evidences of criminal abortion
n In Dead lady
n Always sent for post mortem examination
n Sudden death of a woman of child bearing age
n Dead woman is pregnant and deeply cyanosed
n Pale if death was due to excessive hemorrhage
n Disturbed underclothing
n Evidence of abortifacient drugs/ instruments used
n Soapy fluid/ blood stained fluid coming out of vagina
n Vaginal discharge may have offensive smel / smel of soap/ Dettol/ Lysol
Genital examination often reveals congestion of labia, injury to posterior
commissure



























Evidences of criminal abortion in a dead lady
Continued
n Abdominal cavity may contain clotted blood
n Perforation of pelvic organs may be present
n Uterus findings:- Enlarged size, cavity may contain chemicals/ abortion stick
n Part of product of conception, blood clot
n Findings in the ovaries, lungs, heart, kidneys and others
n Material Preserved
n Uterus, ovaries and vagina:- in formol saline for histopathology
n Part of uterus, part of vagina in S. S. of common salt for chemical analysis
n Other usual viscera as per indication
n Blood and urine also preserved
n Examination of product/ part of product of conception





















Medicolegal aspects of abortion
n Abortion induced without proper indication:- Amounts to crime
n Doctor violating the MTP Act 1971:- liable to be punished
n Pregnant or even non pregnant lady may malinger abortion ?
n due to assault- false charge against enemy.
n Abortion may be feigned:- for blackmailing
n for compensation by a working woman
n A woman may be falsely charged for inducing criminal abortion
n A woman who has aborted:- falsely charged of infanticide
n A woman who has aborted:- may bring charge of negligence against
the treating doctor


















Role of doctor in dealing a case of criminal abortion
n 1. Consult a professional col eague
n 2. Render proper treatment, preserve suspected material, keep detailed record
n 3. Maintain professional secrecy
n 4. If police inquires, must give ful information
n 5. In case of impending death- request for recording of dying declaration
n 6. In case of death of woman- police informed
n - dead body handed to police
n - death certificate not issuied

This post was last modified on 12 August 2021