Community
1) Define maternal
mortality :
- Death
of a woman while being pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and site of the pregnancy, from any cause related
to or aggravated by the pregnancy or its management but not from accidental or
incidental causes.
2) What is meant by
direct obstetric causes of maternal mortality, and what are they?
- Causes
of maternal mortality directly related to pregnancy, labour or puerperium. They
include :
(a) Haemorrhage
(b) Pregnancy
induced hypertension
(c) Genital
sepsis
(d) Unsafe
abortion
(e) Obstructed
labour
(f) Other
causes : thromboembolism, hypovolemic shock, neurogenic shock, amniotic fluid
embolism, etc.
3) Define stillbirth :
- Intra-uterine
foetal death after viability (22 weeks of gestation).
4) Mention causes of
neonatal morbidity :
(a) Prematurity
(b) Congenital
malformation
(c) Infections
(d) Injuries
including birth injuries
5) Mention 4 infections
that lead to neonatal morbidity :
(a) Tetanus
neonatorum
(b) Omphalitis
(c) Ophthalmia
neonatorum
(d) Diarrhoea
& acute respiratory infection (ARI)
Forensic Case:
A
23-year-old male hit a 40-year-old man with a stone to his head. Some hairs
were found on the stone. The victim fainted for a few minutes then he was
transmitted to the hospital in a drowsy state. X-ray of the head revealed a
linear fracture and extradural haemorrhage. Few hours later, the patient became
comatose again.
1) Verify the age of the
victim by X-ray.
- The
body of hyoid bone is united with its greater cornu
- The
xiphoid process is united with the body of sternum
2) Can you determine the
part at which the impact was done?
- Temporal
bone; due to presence of extradural haemorrhage which is most commonly due to
tear of the middle meningeal artery.
3) How could you explain
the loss of consciousness twice by the same trauma?
- The
first coma is due to concussion, followed by lucid interval and the second coma
is due to cerebral compression (increased ICP).
4) Discuss medicolegal
importance of the period between the first and second coma?
- Alleged
negligence
- The
assailant’s defence may claim that the cause of death was not due to the trauma
- The
victim may tell the name of the assailant
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