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Virginity | Hasnat Hussain (Reus-11)

Virginity, Pregnancy, Delivery,


Abortion and Forensic Psychiatry
Q.1 Note on Hazards of criminal abortion.
ANS:
Hazards of Criminal Abortion:
Trauma
Excoriation, laceration, tears and perforations in vagina and uterus due
to various instruments used.
Haemorrhage
Introduction of various instruments into the vagina and uterus
injuries and perforations haemorrhage hypovolemic shock.
Shock
May occur immediately from reflex vagal inhibition when the cervix is
touched.
May occur after the removal of amniotic fluid.
Fat and Air Embolism
Occur when a liquid or soapy solution is injected by a syringe into the
uterus. This causes the separation of the membranes and exposure of
the uterine raw surface through which air and fat (soap) may enter the
maternal circulation, resulting in death from fat or air embolism.
Infections
Common infections which can occur during abortion are pelvic
peritonitis, salpingitis, septicaemia, tetanus and endometritis.
Bacteria responsible for the above mentioned infections are E.coli,
Staphylococci and Streptococci.

Virginity | Hasnat Hussain (Reus-11)

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

Breasts will be full, firm, tender and enlarged.


Surface veins will be prominent.
Areola will be dark.
Montgomerys tubercles will be present.
Colostrum can be secreted out if breasts are squeezed.

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.

Virginity | Hasnat Hussain (Reus-11)

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.

Q.3) Note on False virgin. Discuss the sign and symptoms of


Pregnancy.
ANS:
False Virgin:
False virgin means a woman who has had sexual intercourse without the
rupture of hymen.
It is occurs when the hymen of the woman is elastic and distensible.
In this case;
(i) hymen is intact
(ii) edges of hymen are undulated
(iii) labia minora does not cover labia majora
(iv) labia majora does not cover vagina

Virginity | Hasnat Hussain (Reus-11)

(v) vestibule is wide open


(vi) fourchette torn
Signs and Symptoms of Pregnancy:
Presumptive Signs
(i)
(ii)

(iii)

(iv)
(v)

(vi)

Cessation of menses (Amenorrhea)


Morning Sickness
Nausea and vomiting after waking up in the morning for first
3months.
Sympathetic Disturbances
Increased salivation
Increased appetite
Change in taste
Urinary Disturbances
Increased frequency of urination
Quickening
Movements of the foetus are felt by the mother at 4th month
of pregnancy.
Pigmentation of Skin
A dark line is formed, which extends from the pubis to the
umbilicus, it is called linea nigra.

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.

Virginity | Hasnat Hussain (Reus-11)

Linea albicantes are seen due to stretching of the abdomen.


(iii) Changes in Uterus
Uterus gradually enlarges and its upper end extends up slowly
with the passage of time.
(iv) Changes in Vaginal Mucosal Membranes
Colour of the vaginal mucosa changes from pink to violet and
then to blue due to venous congestion. This is called
Jackquemiers sign or Chadwicks sign.
(v)
Changes in Cervix
Becomes very soft due to increased vascularity. This called
Goodells Sign.
(vi) Softening of Lower part of Uterus
At about 6th week of pregnancy, the lower part of uterus
becomes very soft. This is known as Hegars Sign.
(vii) Intermittent Uterine Contractions
After 4th month of pregnancy, uterus starts to contract
intermittently. This is known as Braxton Hicks sign.
(viii) Ballottment
It is a method for detecting the foetus floating in the amniotic
fluid.
Pressure is applied either externally on the abdomen or
internally in the vagina, due to which the baby will float in the
direction of pressure applied. Movement of the baby can be
felt by palpation on the abdomen.
(ix) Uterine Scouffle
A murmur is heard from the abdomen by a stethoscope after
4th month of pregnancy. This is due to the passage of blood
through the uterine vessels.
(x)
Biological Tests
Pregnancy tests become positive due to the presence of HCG
hormone in the urine.
Conclusive Signs
(i)

Foetal Heart Sounds

Virginity | Hasnat Hussain (Reus-11)

(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.

Q.4) Describe (i) Morphological features of a full term foetus


(ii) Hydrostatic Test
ANS:
Morphological features of a full term foetus:

Crown-heel (head to heel) length is about 48-52 cm


Crown-rump (head to buttocks) length is about 28-32 cm
Head circumference is about 30-35 cm
Weight about 2500 to 3300 grams
Head is well covered with hair about 2-3 cm in length
Lanugo (fine and soft hair) is seen only over shoulders.
Skin is covered with vernix caseosa (white, cheesy substance
made up of sebaceous secretion and epithelial cells)
Pupillary membrane is absent
Cartilages in the nose and ears are present
Umbilicus is present at the midway b/w xiphisternum and
symphysis pubis
Both testes descended in to the scrotum or labia has closed the
vulva
Meconium (green, viscous made up of bile and mucous) is
present in the large intestine
6

Virginity | Hasnat Hussain (Reus-11)

Ossification centres are present

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.

Q.5) Note on Sadism.


ANS:
Sadism:
Sexual Perversion in which the infliction of pain is necessary for sexual
pleasure.
Common in males.
The sadist bites, whips, injures or ill-treats the partner.
Injuries may be inflicted on any part of the body but breasts and
genitalia are commonly selected.
Complications;
The sadist may commit a murder of his partner (lust murder).
The sadist may have a sexual intercourse with a dead body (necrophilia).
The sadist may tear out genitals or other organs and drink the blood or
eat flesh to satisfy sexual desire (necrophagia).

Virginity | Hasnat Hussain (Reus-11)

Q.6) Note on (i) Delusions (ii) Hallucinations


ANS:
Delusions:
Delusion is a false, but firm belief in something which is not a fact.
It affects the conduct and actions of the sufferer, and may lead him to
commit suicide, murder, or some other crime.
Such a person is not fully responsible for his acts.
Types
(i)

(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:

Virginity | Hasnat Hussain (Reus-11)

A false perception without a sensory stimulus.


In simple words, hallucination means seeing, hearing, smelling, tasting or
touching something that is not actually present.
Types
(i)
Visual Hallucinations
Patient sees flashes of light, frightening faces, wild animals or terrifying
scenes.
(ii)
Olfactory Hallucinations
Patient smells bad things in his room.
(iii) Taste Hallucinations
The patient tastes bad food when he eats anything.
(iv) Tactile Hallucinations
Patient feels bugs creeping sensations under the skin.

Prepared By: Hasnat Hussain (REUS11)


(gullaly)

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