 Definition

 Classification
 Methods of criminal abortion
 Complications
 Causes of death
 MTP – Indications , rules , Punishment
 Prematureexpulsion of the fetus from
mother’s womb at any time of
pregnancy, before full term of
pregnancy is completed.
 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
 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
1.Using Abortifacient drugs
2.General violence
3.Local violence
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
 Intentional – kicks, jumping, massage

 Violent exercise – horse riding , cycling

 Cupping – a mug is used to separate placenta

 Accidental – violent shaking the body

 Syringing – enema syringe, Higginson's syringe
 Rupture of membrane
 Dilatation of cervix & curettage
 Abortion stick
 Air insufflation
 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
 Cervicalcanal may be dilated, mucus plug in
the cervix

 Collectionof fluid in peritoneal cavity –

rupture of uterus
 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
 Immediate: Vagal inhibition, Air embolism,
Haemorrhage, Fat embolism, Amniotic fluid
embolism

 Delayed death : Pyaemia, Septicemia ,

peritonitis, Renal failure, Pulmonary
embolism
 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
 Who can terminate pregnancy ?
 Place of MTP ?
 Consent
 Duration of pregnancy
 Medico legal aspects
- 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 women
2. Minor or mentally ill – guardian
3. 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 ?
 Terminationof 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)