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Poisoning
Drugs used for abortion GIT disturbance, CNS manifestations, coma
or death can occur.
Q.2) Give the sign and symptoms of recent delivery in a young lady.
ANS:
Signs and Symptoms of recent delivery in a young lady:
General Appearance
If it is her first delivery, she will be pale, anaemic and weak.
She will have an ill looking face, sunken eyes and dark pigmentation
below the eyes.
Temperature and heart rate is increased.
After Pains
The uterus will contract and intermittently for 4-5 days after delivery.
This will cause pain.
Breasts
Abdomen
Abdomen will be lax, wrinkled and flabby (pendulous).
Linea albicantes and linea nigra can be seen.
Uterus
Uterus will be very hard and can be felt like a hard cricket ball at the
lower part of abdomen.
Vulva
Bruised and wide open. Perineum region will be inflamed and lacerated.
Cervix
Hymen is ruptured.
Internal os closes within 24 hours while the external os closes after 2-3
days.
Lochia
It is a discharge from the uterus and vagina after the delivery for 14-15
days.
It has a bad odour. It contains RBCs, WBCs, debris, vaginal epithelium
and cholesterol.
In first 3-4 days, it is red and it is known as Lochia Rubra.
In the next 3-4 days, it changes from red to pale colour and its called
Lochia Serosa.
In the next 4-5 days, the colour changes to yellowish grey or slightly
greenish and its called Lochia Alba.
(iii)
(iv)
(v)
(vi)
Probable Signs
(i)
(ii)
Changes in Breasts
Enlarged, firm and full.
Nipples are hard and erected.
Areola size increased and becomes darker.
Montgomerys tubercles are formed.
Colostrum can be squeezed out.
After 6 months, silver lines appear on the breasts due to
stretching.
Surface veins become prominent.
Changes in Abdomen
Becomes full, enlarged and distended.
(ii)
(iii)
(iv)
B/w 4th to 9th month of pregnancy, pulse and heart rate of the
foetus can be felt and calculated.
Palpation of Foetus
Foetus can be palpated after the 4th month of pregnancy.
Radiographs
After 4th month of pregnancy, ossification centres of the baby
can be detected by X-rays.
Ultrasound
Ultrasound is the most common method used nowadays to
confirm pregnancy. It can detect foetal heart beats, size,
movement etc.
Hydrostatic Test:
A biological test to determine whether an infant breathed prior to its death or
not.
It depends on changes in the specific gravity of lungs due to respiration.
The specific gravity of a non-respired lung is 1050 (heavier than water)
and that of a respired lung is 950 (lighter than water).
Non-respired lungs therefore sink in water and the respired lungs will
float.
Lungs are cut into lobes and then into pieces squeezed put in
water check floatation
This test is of no value in forensic medicine due to its various drawbacks.
(ii)
(iii)
(iv)
(v)
(vi)
Delusion of Grandeur
Occurs in mania and schizophrenia.
The person thinks that he is a king, president or has divine
powers.
Delusion of Infidelity
Occurs in chronic alcoholism and schizophrenia.
The patient thinks that his/her partner is not loyal and assaults
him/her.
Delusion of Persecution
Occurs in schizophrenia and mood disorders.
The person thinks that he is going to be killed by his relatives.
Delusion of Poverty
Occur in depression.
The person thinks that he is poor.
Nihilistic Delusion
The patient thinks that the world does not exist, he does not
exist and he is dead.
Hypochondrial Delusion
Occurs in late stages in life.
The patient may think that he has cancer, unable to swallow or
his bowels are obstructed etc.
Hallucinations: