Abortion Final
Abortion Final
Abortion Final
• Still born ;a viable fetus was alive in the uterus and is born but does
not show any signs of life after being born.
• This can be found by absence of signs of live birth.
• The child should show the age of viability i.e. more than
28weeks/7months of intra-uterine life.
• This can be found by usually:
• Measure the C-H length of the child in centimeters.
• Divide this figure by 5 and that will give you the age in months.
• The age of viability is 7 months. This means the infant is capable of
separate existence
Still born
• Put simply, the birth of a dead fetus that was
viable
• A still birth certificate may be issued by the
medical practitioner present at birth
• A fetus less than 28 weeks is not considered
viable, thus need not be registered as a still birth
in some states and the fetus be disposed as
biological material or otherwise as no burial
order will be issued ;
Dead born
• A dead born; a viable fetus that was
already dead while still in the uterus.
Clinically this will be seen as a macerated
still birth
Duration of Pregnancy
Abortion
• Abortion:- If terminated before
placenta is formed i.e.,10weeks
then it is called abortion ie zygote,
embryo, very early fetus
Duration of Pregnancy
miscarriage
• Miscarriage:- If terminated between 10
weeks or 3 months and 28
weeks/7months it is called miscarriage ie
non viable fetus
• NB; this is the legal statutory defn as in
clinical practice fetal viability begins at 20
weeks
Duration of Pregnancy
premature labour
• Premature labour:- If terminated between
28 weeks and 40 weeks it is called
Premature labour.
Types
• Spontaneous and Induced.
• Spontaneous: When it occurs on its own
or without artificial interference. This takes
place due to any disease like viral
infections viz; Rubella, measles or other
severe toxaemias, etc., small uterus
infantile uterus, etc. Genetic defects are
also a major cause
Induced Abortion
• This is done by artificial interference with the pregnancy.
This can be :-
• Therapeutic
• Criminal
• Therapeutic abortions are done when the continued
pregnancy would be dangerous to health or life of the
female or the foetus. If possible you may wait till the age
of viability of the foetus. This way you may save two lives.
• The indications for Therapeutic abortion are:-
• Advanced cardiac conditions/failure
• Advanced tuberculosis, Sepsis, Toxaemia of pregnancy,
carcinoma cervix, etc. etc , hiv
• Rape
Criminal Abortions:
• Perform a full
• Apart from identification
• Distinguishing between a live birth and a
still birth helps to determine whether the
courts will treat this as infanticide or just
concealment of a birth
Born alive or stillborn
Born alive stillborn
Lungs Expanded, fill thorax, Atelactic, lie close to rib
mottled light red, crepitus, cage, uniform dark red
round edges purple
Hydrostatic test Float in water Sink in water
git Gas in stomach, milk in No gas, no milk
git
Umbilcal cord Inflm ring around navel
After 30hrs confirm with
histo, falls of in 5 to 9
days
Maceration Macerated if born dead
Vernix caseosa ? Can be washed of
Patent pdaor foramen Not proof of a still birth;
ovale can remain patent for a
few days
Hydrostatic test
• Not fool proof
• Lungs may float due to
I. Resusc efforts
II.Decomposition
• Lungs may sink due to ;
I. Consolidation
II.Incomplete lung expansion in prematurity
Other issues at autopsy
• Maturity; weight, chl, crl, ossification
centres by radiology
• Length of survival; food, umbilical cord
• Timing of death; difficult, quick temp fall,
quick rigor mortis, sterile babies
decompose longer, is it decomposed or
macerated
• Cause; natural vs unnatural
• identity
Causes of Death
• This can be by: acts of commisson
• : acts of ommision
• Acts of commission:
• Injuries, asphyxia, poisoning etc.
• Acts of Omission:
• Failure to provide necessasities such as not
properly cutting umbilical cord
• Shelter, food clothing etc.
•
Finding and relation with woman
• A woman who is brought examination
should be examined for proof of her
having delivered. The age of labour should
be established.
• DNA test will relate the mother to the child
as well as the blood groups.