PREGNANCY

Definition:

The state of carrying a developing

embryo or fetus within the female
body.

Reproductive age group: 14-45 years.

Medico legal significance:
1. As a witness

2. Death sentence Sec. 416 Cr.P.C.

3. Succession of estate

4. Breach of promise of marriage

5. Blackmailing
Medico legal significance:
6. Separation

7. Death of husband compensation

8. As a motive for suicide/homicide

9. Divorce cases

10. Concealment of birth/infanticide

Diagnosis of pregnancy:
A) The Presumptive signs

B) The Probable signs

C) The Positive signs

A] PRESUMPTIVE SIGNS:
1. Amenorrhea
2. Changes in breasts 2nd month
Colostrum
3. Morning sickness 1month -3 months
4. Quickening 16 20 weeks
5. Pigmentation of skin- Linea nigra
6. Changes in vagina
7. Urinary disturbances
8. Fatigue
9. Sympathetic disturbances -
1. Amenorrhoea:
- Earliest.
- But there are several other causes of
amenorrhoea.
- Pregnancy can occur in a woman who never
menstruated or during period of lactational
amenorrhoea.
2. Changes in Breasts:
- Important in primi.
- 2nd Month:
- Enlarged, nipples pigmented,
Montogomory tubercles.
- 3rd month:
- Colostrum
- 6th Month: Striae
Colostrum
3. Morning Sickness:
- 1st to 3rd month.
- Very unreliable.
4. Quickening:
-4-5 months
- Movements of the foetus felt by mother.
5. Pigmentation of skin:
Linea Nigra.
Linea Nigra
6. Changes in Vagina:
- Jackquemiers sign/ Chadwicks sign.
-4weeks

- Mucosa of vagina Pink to blue.

- Increased uterine secretions.
7. Urinary disturbances:
Enlarging uterus giving pressure on
bladder.

- Disappear after few weeks as uterus rises

in abdomen.

- Reappear when head descends.

normal uterus
8. Fatigue:

9. Sympathetic disturbances:
B] PROBABLE SIGNS :
1. Enlargement of abdomen
2. Uterus Hegars sign 6th week
3. Cervix Goodells sign 2nd month
4. Intermittent uterine contractions
- Braxton Hicks sign 4th month
5. Ballottement 4-5 th month
6. Uterine Souffle 4th month
7. Biological Tests -
8. Immunological Tests -
1. Enlargement of Abdomen:
2. Hegars Sign:
- 6th week.
- soft isthmus between firm cervix &
elastic uterus.
3. Goodells sign:
- 2nd - 4th month
- Progressive softening of cervix from
below upwards.
4. Braxton- Hicks Sign:
- 4th month
- Intermittent, painless uterine
contractions.
5. Ballotment:
- Means tossing up like a ball.
- Internal:
- External:
6. Uterine Souffle:
- Soft murmur synchronous with mothers
pulse.
7. Biological Tests:
- Not done now a days.
8. Immunological Tests:
- Increased level of HCG
- Can be detected after 8 days.
- Convenient & reliable
- Urine or serum
- 8th day of impregnation.
- Can be positive in ovarian diseases.
C] POSITIVE SIGNS:
1. Foetal parts & movements
2. Foetal heart sounds
3. X ray
4. USG
1. Foetal Parts & Movements:
- Movements 24 weeks
- Parts 36 weeks.
2. Foetal Heart Sounds:
- First time: 18-20 weeks.
- Rate of FHS in 9th month 120
- Not heard,
a. Dead foetus
b. Excessive liquor amnii
c. Very fat abdominal wall
3. X-ray Examination:
- 16th week
- Not advisable
- Spalding Sign:
- Dead foetus.
X ray showing twin
fetuses
4. Ultrasonography:
- Most preferred.
- Gestational sac 6th week
- Embryo 7th week
- Fetal heart beat 10th week
- Fetal head 14th week.
Pseudocyesis:
Spurious or phantom pregnancy

- Mental illness
The period of Gestation:
a] Average:
- 280 days from the 1st day of LMP
i.e. approximately 270 days.
b] Maximum:
- Several studies
- 354 days from conception to live birth.
c] Minimum:
210 days ( viability)
Posthumous Child:
Superfecundation:
Fertilization of two ova discharged
from ovary at same period by two
separate acts of coitus.
- Binovular twins.
- Foetus compressus or papyraceous.
Superfoetation:
- Fertilization of second ovum in a woman
who is already pregnant.
- Chances are more in a bipartite or double
uterus.
The Preconception and Prenatal
Diagnostic Techniques Act:
PCPNDT Act.