C15: Abortion

🩺 Forensic Abortion – Summary

🔹 Definition

Abortion is the *expulsion or extraction of the products of conception from the uterus before the fetus becomes viable* (≈ before 28 weeks or 1 kg weight).

🔹 Types of Abortion

🔹 Methods Used

1. Mechanical

– foreign bodies (sticks, catheters) → uterine perforation

2. Chemical

– irritant or toxic substances (e.g., *savine, ergot, lead oleate*)

3. Drugs– oxytocin, ergot preparations stimulate uterine contraction

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🔹 Diagnosis in the Living

* History of amenorrhea, abdominal pain, bleeding.

* Local signs: vaginal or cervical tears, dilated os, expelled tissue.

* Examination requires

*informed written consent.

* Products should be sent for histopathology and chemical analysis

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🔹 Post-Mortem Findings

*Torn or perforated uterus/cervix.

* Retained or infected products of conception.

* Pelvic hemorrhage and peritonitis.

* In septic cases: foul smell, pus, uterine and peritoneal infection.

* In air embolism: frothy blood in right heart.---

🔹 Causes of Death

1. Hemorrhagic shock

2. Septicemia and peritonitis

3. Air or gas embolism

4. Injury to uterus or viscera

5. Tetanus

6. Toxicity... from abortifacients

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🔹 Medicolegal Aspects

*Therapeutic abortion*: legally permitted under defined conditions.

*Criminal abortion*: unlawful and punishable; examination must establish:

* Whether pregnancy existed. * Whether abortion occurred. * Method and instrument used. * Whether the woman was alive when it was done.

*Consent & Documentation* are mandatory.

* The examiner should preserve all evidence (tissues, instruments, poisons).---

🔹 Key Forensic Clues

*Therapeutic → hospital, consent, safety.

*Criminal → secrecy, sepsis, sudden death.

*Primary hemorrhage → immediate; secondary → after sepsis.

* *Air embolism → frothy right heart blood, sudden collapse.

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🧠 Mnemonics

*A B O R T I O N* →

*A – Age < 28 weeks ;

*B – Bleeding vaginal;

*O – Oxytocic drugs;

*R – Rupture uterus;

*T – Toxin or Trauma;

*I – Infection (sepsis);

*O – Outlawed (criminal);

*N – Not viable fetus.