1. Pregnancy & Delivery
Dr. Ganesh Govekar

2. Delivery Abortion Disputed paternity Infanticide Legitimacy Nullity
Property inheritance
Divorce-Higher maintenance
Higher compen-husband death
Execution of death sentence
Leave in services
Homicide/suicide

3. Definition
Complete evacuation of fetus and other conceptional product after attaining the viability.
Full Term
Pre term
Post term

4. Signs and Symptoms in Recent
Fatigue-more in prolonged labour
Loss of weight
Diuresis- physiological reversal
Afterpains- milder after 3 days, 7th day disappear
Post partum fever (milk fever)
Transient depression (peurperial Psychosis)

5. signs Breast- colostrum(2 days) later pure milk
Abdomen- linea albicans Caeserian section
Vagina-smooth walled, relaxed, wide, ironed rugae, lacerated walls, carunculae multiformis
Labia-swollen
Perineum- ruptured fourchette and posterior comm
Lochia- alkaline discharge, sour disagreeable odour
Consists of rbc, wbc, decidual sheds, epithelial cells and bacteria
Lochia rubra- upto 4 days
Lochia serosa-5th to 10th day
Lochia alba- 10th day onwards upto 2-3 weeks

6. Cervix- thin collapsed and flabby
External os – laceration of outer margin, contract slowly, 2nd day- two finger, 1 wk- one finger
Wall thickened to re-establish.
Uterus- involution
1-3 day-fundus midway between umblicus and pubic symphysis
5-6 week- normal size
Lab test- biological test- positive upto 7-10 days after delivery.

7. In dead ( Recent-Delivery signs)
As above and
Uterus-

8. Signs of recent Delivery in dead
Uterus 0 D-20×15 cm-1kg 4-5 cm thick 2-3D-17.5×10cm-800gm 1 wk- 5×3×2inch-1/2 kg 2 wk-3×2 -350gm 6 wk-N(7-8cm) gm Placental sites 15cm-shortly 3-4cm-2nd wk 1-2cm-6wk

9. Ovaries & fallopian tubes – congested for few days
- large C.L. in one ovary
Uterus morphology:-
LSCS-fresh healing incision
-Ant & post wall- 4-5cm thick(soon after delivery)
-myometrium-basal decidua only
-placental site – palm size

10. -an ischemic appearance 3) 2-3 days- decidua-2layers 1
-an ischemic appearance 3) 2-3 days- decidua-2layers 1.) Sup-necrotic 2.) Basal-shed in lochia 4) 2 wk – endometrium- -placental site- 3-4cm 5) 5-6 wk- placental site get covered by endometrium

11. Signs of REMOTE DELIVERY in living
1.ABDO – lax - wt scar-lat wall - linea nigra-present 2.Breast – lax,pendulus soft,wrinkled-due to feeding - linea albican - nipple-enlarged - areola-large,dark,montgomery tub. 3.Vulva- partialy open -perineum-scar

12. 4. Vagina- rugae-absent & walls lax 5
4.Vagina- rugae-absent & walls lax 5.Cervix- ext os-large, transverse In vagina-simple-dimple

13. Signs of Remote in dead Uterus- large thicker, heavier -walls- concave
- body twice the cervix.
IN DEAD:-
Ovaries & F.T. – congested, M.E. – C.L-intact/degenerated
Peritoneum- wrinkled & folded
Ligaments 1) broad &2) round –lax, take long time to recover

14. Positive signs of pregnancy:
FHS
Fetal parts
Fetal movements
X ray wk
USG wk
IN DEAD 1. enlarged uterus
2. C.L. progre/regre
3. conception product

15. Superfetation: Twin preg- 2 ova fert at diff cycle Superfecundation: 2 ova discharged at a time Pseudocyesis: false/spurious preg. Pregnancy N-280days max days min days Negeles rule:- 9m + 7days

16. FHS- definate signs wks - Muffeled sound not synchronus with mother pulse X ray wk - skull-crescentric - vert col- dots - ribs- curved parallel shadow/lines - limbs - linear shadow spalding collapse- V.C Gas-Heart & Vs.

17. Sonography - Gast ring- 6 wk Embryo -8wk F H beat - 12 wk Head & thorax -14wk Dx – IUGR - malformation

18. Prenatal diagnosis technique Act
1.Prohibit Dx for sex determination- female foeticide 2.Permit Dx for detection of genetic abnormality Central Govt.- central supervisary board to review implimentation of act. Genetic councelling centre- Get regd. By appro authority. To be done by- Qualified person Consent from female.

19. Test done if following condition satisfied:
Female >35
H/O ≥ 2 spont abortion
H/O exposure to teratogenic agent
H/O mental retardation.
Test done for detection of. 1.Chromo. Abn.
2.Genetic/metabolic disorder
3. Hb. Pathy
4.sex linked disorder
5. cong. Abn.
Act provides – Appeal
- conviction – Dr -3yr Rigourus
- fine 5000
-prof death sente
-perm removal for subsequent offence.