Some Discussion about Pregnancy on Forensic Medicine

মাগরিবের ওয়াক্ত হয়ে গেছে। আনিকা আযানের আওয়াজ শুনতে পেল। ওযু করে নামাজ পড়ে নিল। পরের দিন প্রেগন‍্যান্সি আইটেম। তাই আনিকা সময় নষ্ট না করে রুপার সাথে গ্রুপ স্টাডি করা শুরু করল….

রুপা:- দোস্ত বলতো, প্রেগন‍্যান্সি কি?
আনিকা:➡️Pregnancy may be defined as the physiological state of a women in which ovum is fertilized & implanted into the posterior wall of the uterus and subsequently grows to a full term fetus.
রুপা: আচ্ছা। এখন বলতো, Types of pregnancy ?
আনিকা:☑️True pregnancy.
☑️False pregnancy.
রুপা:Duration of pregnancy?
আনিকা:➡️Normal–280 days plus minus 7 day / 40 weeks / 9 month calender plus 7 days from the first day of Last Menstrual cycle.
রুপা: ওকে।😊
আনিকা: দোস্ত Medicolegal importance of pregnancy গুলো বলতো?
রুপা: 🛡️Relating to criminal case–
☑️Execution of death sentence.
☑️Exemption of trial.
☑️Pregnancy may be the result of rape, kidnapping & seduction etc.
☑️Pregnancy in an unmarried girl of 16 years or less and in a married girl of 15 years or less point towards commission of the offence of rape.
☑️Pregnancy may be claimed after adultery.
☑️Illegal pregnancy may be the cause of homicide.
☑️Illegal pregnancy may predisposes suicide.
☑️In unmarried women and widow question of pregnancy in intimately related with abortion or concealment of birth case.
🛡️Relating to civil cases-
☑️Nullity of marriage.
☑️Decree of divorce.
☑️Inheritance of pregnancy.
☑️In divorce situation a women is allowed her higher compensation if she is
☑️A working pregnant women is allowed to additional leave facility.
আনিকা: আচ্ছা। 😊
রুপা: এখন বলতো.. Sign of pregnancy?
আনিকা:-🔴 Presumptive sign:-
☑️Amenorrhoea— Cessation of menstruation. It may be due to other causes.
☑️Changes in the breast— ~Breast enlarge.
~But in the early morning, tingling and tense feeling.
~Montogomery’s tubercle appears.
~On the 3rd month onwards, yields secretion of colostrum on squeezing of breast and nipple.
☑️Morning sickness.
☑️Vomiting (অনেক সময় long time থাকতে পারে – একে hyperemesis gravidarum বলে )।
☑️Pigmentation of the selective parts of the skin
~Eyelids, axilla & areola of the breast – darken during pregnancy.
☑️Appearance of linea nigra–
~A vertical area of dark pigmentation on the front of the abdomen from umbilicus to symphysis pubis.
☑️Striae gravidarum–
~Multiple transverse strips of pinkish / silver coloured on the front and sides of anterior abdominal wall.
☑️Increase frequency of micturition.
☑️Quickening--The perception of 1st movement of the fetus by a mother.
☑️Jacquemier’s sign/ chadwick’s sign–
~Changes in the vaginal wall from pinkish to violet or bluish colour.
11.Desire for spicy and irritant temperament.
🔴Probable sign:-
☑️Gradual enlargement of abdomen.
☑️Height of the uterus–
~12 weeks – symphysis pubis
~16 weeks- in between symphysis pubis and umbilicus.
~20 weeks- near the umbilicus
~24 weeks- at umbilical level
~28 weeks- about 1 inch above the umbilicus.
~32 weeks- almost midway between the umbilicus and xiphisternum.
~36-37 weeks- reaches the xiphoid process but with the further advancement it reduces in height owing to the foetal head.
~After 37 weeks- enter the true pelvis.
☑️Hegar’s sign–
~During 2nd month, body of the uterus is soft, the cervix is comparatively firm which is detected by bimanual examination.
☑️Goodell’s sign–
~Cervix becomes soft and bluish discolouration of cervix during 2nd month.
☑️Uterine souffle–
~It is soft blowing murmur which is synchronous with mother’s pulse.
☑️Ballottement test–
☑️Braxton Hicks test–
~Intermittent uterine contraction
☑️Test of urine for human chorionic gonadotropin hormone.

🔴Positive sign:- ☑️Auscultation of foetal heart sound (First heard in between 18-20 weeks. Rate is 160 at 5 month & 120 at 9 month).
☑️Palpation of foetal parts.
☑️Perception of foetal movement.
☑️Ultrasonogram:- Gestational ring is seen.
আনিকা:-Confirmation of pregnancy?
রুপা:☑️Immunological test (HCG).
☑️Ultrasonography of the abdomen.

আনিকা:📌Pseudocyesis কী?
রুপা:➡️In this condition the women presents all or many subjective signs of pregnancy including swelling of abdomen, quickening etc.
আনিকা:📌Condition, Diagnosis & Treatment of pseudocyesis?
রুপা:➡️Condition:☑️Childless women.☑️Women near to the menopause.

➡️Diagnosis:☑️Absence of positive sign of pregnancy.
☑️Immunological test:- negative.
☑️Ultrasonogram: Absence of fetus.

☑️Advise the family member to support her.
আনিকা:📍Superfoetation & Superfecundation কী?
রুপা:🔵Superfoetation: It is a condition of a women in which two different ovum fertilized during different cycle where two fetus develops, one being more mature than the other and delivered altogether or in separate time.
🔵Superfecundation: It is a condition of a women in which two ovum fertilized at different coitus in the same cycle.
আনিকা:আচ্ছা। এশার নামাজ পড়ে চল ডিনার করে ফেলি। ইনশাআল্লাহ কালকের আইটেমে ভালো মার্ক পাবো।
রুপা: ইনশাআল্লাহ।☺️

Reference :-The essentials of Forensic Medicine &Toxicology,34th edition.

platform academic/
Mst.Foyzunnahar Akanda Poly

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