This document discusses abortion, including its definition, classification, methods, complications, causes of death, and medical termination of pregnancy (MTP) regulations. It defines abortion as the premature expulsion of the fetus before full term of pregnancy. Abortions are classified as natural, which occur spontaneously due to natural causes, or artificial, which are either therapeutic to save the woman's life or criminal. Criminal abortions are induced unlawfully through abortifacient drugs, violence, or medical instruments and can cause maternal death through complications like infection, hemorrhage, or organ perforation. The document outlines the rules and punishments around MTP in India.
2. Definition
Classification
Methods of criminal abortion
Complications
Causes of death
MTP – Indications , rules , Punishment
3. Premature expulsion of the fetus from
mother’s womb at any time of
pregnancy, before full term of
pregnancy is completed.
4. 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
5. Maternal
Foetal
Diet – deficient in calcium, iodine
Defective fertilization – inherent defect in
sperm or ova
6. Criminal abortion – Induced destruction
and expulsion of the fetus (products of
conception) from the womb of mother
unlawfully
8. 1. Drugs acting directly on uterus
a) Ecbolics - Ergot , quinine, lead
b) Emmmenagogues – causes increase in menstrual
flow – savin, borax, oestrogen
2. Irritants of Genito urinary tract
- Produce reflex uterine contraction
- oil of turpentine, cantherides
3. Irritants of GI tracts
- irritation of colon- hyperaemia & contraction of
uterus
- castor/croton oil, Senna, Magnesium Sulphate
9. Intentional – kicks, jumping, massage
Violent exercise – horse riding , cycling
Cupping – a mug is used to separate placenta
Accidental – violent shaking the body
10. Syringing – enema syringe, Higginson's syringe
Rupture of membrane
Dilatation of cervix & curettage
Abortion stick
Air insufflation
11.
12.
13. 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
14. Cervical canal may be dilated, mucus plug in
the cervix
Collection of fluid in peritoneal cavity –
rupture of uterus
15. 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
18. 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
19. Who can terminate pregnancy ?
Place of MTP ?
Consent
Duration of pregnancy
Medico legal aspects
20. - Registered Medical Practitioner (MBBS)
- RMO if assisted 25 cases of MTP in a
recognized hospital
- MD, Diploma in OBG
21. Place of abortion
- Govt Hospital
- Hospital recognized by Govt
- Private hospital after taking license from
District Health Officer
Consent –
1. Written informed consent from women
2. Minor or mentally ill – guardian
3. If husband requests for abortion?
22. 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 ?
23. 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)