Abortion & mtp
-
Upload
fmt -
Category
Health & Medicine
-
view
323 -
download
1
Transcript of Abortion & mtp
ABORTION & MTP ACT
Definition Classification Methods of criminal abortion Complications Causes of death MTP – Indications , rules , Punishment
Premature expulsion of the fetus from mother’s womb at any time of pregnancy, before full term of pregnancy is completed.
CLASSIFICATION Natural – a) Spontaneous b)Accidental
Artificial – a)Therapeutic ,b) Criminal
Natural abortion –any time due to natural causes (common in 2nd or 3rd month)
Therapeutic or justifiable abortion –when it is done in good faith to save the life of women
CAUSES OF NATURAL ABORTION Maternal Foetal Diet – deficient in calcium, iodine Defective fertilization – inherent defect
in sperm or ova
Criminal abortion – Induced destruction and expulsion of the fetus (products of conception) from the womb of mother unlawfully
METHODS OF PROCURING CRIMINAL ABORTION
1.Using Abortifacient drugs 2.General violence 3.Local violence
1. ABORTIFACIENT DRUGS 1. Drugs acting directly on uterus a) Ecbolics - Ergot , quinine, leadb) Emmmenagogues – causes increase in
menstrual flow – savin, borax, oestrogen2. Irritants of Genito urinary tract - Produce reflex uterine contraction - oil of turpentine, cantherides3. Irritants of GI tracts - irritation of colon- hyperaemia & contraction
of uterus - castor/croton oil, Senna, Magnesium Sulphate
2. GENERAL VIOLENCE Intentional – kicks, jumping, massage
Violent exercise – horse riding , cycling
Cupping – a mug is used to separate placenta
Accidental – violent shaking the body
3.LOCAL VIOLENCE Syringing – enema syringe, Higginson's
syringe Rupture of membrane Dilatation of cervix & curettage Abortion stick Air insufflation
POST MORTEM EVIDENCE OF ABORTION GI tract may show evidence of traces of
drugs, erosions or congestion of cervix or uterus
Instrumental abortion – injury to cervix, vagina, uterus. Blood clots or bleeding , products of conception or placental tags
Segments of intestine, mesentery may enter uterine cavity
Ragged or irregular tears of small or large intestine
Cervical canal may be dilated, mucus plug in the cervix
Collection of fluid in peritoneal cavity – rupture of uterus
COMPLICATIONS OF CRIMINAL ABORTION Cervical necrosis Laceration, perforation of vagina, cervix Vagal inhibition Thrombo-phlebitis – injury to vessels Air embolism Bleeding – hemorrhage & shock Perforation of uterus , salpingitis ,
oophoritis Peritonitis Septicemia
CAUSES OF DEATH Immediate : Vagal inhibition, Air
embolism, Haemorrhage, Fat embolism, Amniotic fluid embolism
Delayed death : Pyaemia, Septicemia , peritonitis, Renal failure, Pulmonary embolism
MEDICAL TERMINATION OF PREGNANCY -1971 Therapeutic – when women life is in
danger if pregnancy is continued Eugenic – when there is risk of child
being born with serious physical or mental abnormalities (Measles, small pox, any viral infection, TORCH, Drugs)
Humanitarian – pregnancy caused by rape
Social – failure of contraceptive methods in married women
Environmental – poor economic status which affects mother/child health status
RULES Who can terminate pregnancy ? Place of MTP ? Consent Duration of pregnancy Medico legal aspects
WHO CAN TERMINATE ?
- Registered Medical Practitioner (MBBS) - RMO if assisted 25 cases of MTP in a
recognized hospital - MD, Diploma in OBG
Place of abortion - Govt Hospital - Hospital recognized by Govt - Private hospital after taking license
from District Health Officer
Consent – 1. Written informed consent from women2. Minor or mentally ill – guardian3. If husband requests for abortion?
Register has to be maintained Duration of pregnancy - if < 12 weeks : single doctor - > 12 weeks : two doctors must agree
that there is an indication - In case of emergency ?
PUNISHMENT Termination of pregnancy by a person
who is not RMP or in an unrecognized hospital shall be punished with rigorous imprisonment for a term which shall not be less than 2 years but may extend to 7 years.
Miscarriage without the consent of women – imprisonment up to 10 years (Sec.313 IPC)