- Abortion 2023
- Chapter from book 2025
- د. خالدإلى الدقيقة ٥٠ ، + التفريغ
🩺 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
---
🔹 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
---
🔹 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
---
🔹 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.
---
🧠 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.
🩺 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
---
🔹 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
---
🔹 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
---
🔹 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.
---
🧠 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.