Virginity: a virgin is a woman who has never had any sexual intercourse.
Defloration: loss of virginity
SIGNS OF VIRGINITY
- Breasts: hemispherical, firm and rounded.
- Nipple: small, undeveloped, areola is pink.
- Labia majora: firm, elastic, rounded & completely.
- Labia minora: soft, smooth, small, sensitive & pink in color.
- Fourchette & posterior commisure: intact.
- Vaginal wall: closely approximated.
- Vaginal mucosa: rugose, reddish, sensitive to touch.
- Hymen: intact, deeply situated in children & superficial after puberty, soft to firm in consistency & usually annular or semilunar in shape.
Different types or shapes of hymen:
- Annular or circular (with a central aperture)
- Cresentic or semi lunar
- Fimbriated or notched
- Septate (divided into two openings by a septum)
- Cribiform (with several openings)
Difference between fimbriate & torn hymen
- Notches are symmetrical
- Notches occur anteriorly
- Do not extend to vaginal wall
- Mucus membrane intact
- No signs of inflammation
- Usually posteriorly
- Extend to vaginal wall
- Signs of inflammation present
Signs of defloration:
- Carunculae myrtiformes: several small, granular tags or knobs of tissues (remnants of hymen).
- Labia majora & vagina: lose of tone and rugosity.
- Labia minora: leathery and hard.
Conditions causing ruptured hymen before coitus
- Instrumentation by doctors
- Artificial dilatation of vagina by foreign bodies for prostitution
- Passage of large blood clots
- Hymen is intact & the woman has had no sexual intercourse.
- It only admits tip of little finger in vagina.
- Hymen is intact but the woman has had sexual intercourse
- It can easily admit two fingers in vagina.
MLI of Virginity
- Defamation (chastity)
Signs of prgenancy in living:
- Cessation of menstruation
- Morning sickness
- Sympathetic disturbances (salivation, altered taste, irritable temper)
- Quickening (movement of fetus felt by mother) – after 14-18 weeks
- Frequency of micturation
- Breast changes
- Skin changes
- Vaginal changes
- Changes in cervix
- Hegar’s sign (softening & compressibility of lower uterine segment from 2nd to 5th month)
- Progressive enlargement of abdomen
- Braxton Hick’s sign: intermittent contraction & relaxation of uterus after 4th month
- Uterine souffle (soft blowing murmur heard by 3rd or 4th month)
- 2nd month: breast becomes full & tender, increase in size, veins become prominent, nipples enlarged, areola wider & darker, Montgomery’s tubercles (ENLARGED SEBACEOUS GLANDS)appear.
- 3rd month: colostrum can be squeezed out of the nipples.
- 6th month: lines like linea albicantes appear on breast due to stretching.
- Pigmentation of abdomen, axillae, pubis & vulva.
- A dark line extends from symphysis to umbilicus called linea nigra.
- Pressure of the gravid uterus >> increased vascularity >> mucosa becomes purple or bluish purple >> Jacqueimier’s sign.
- 4th month- pulsation of vaginal arteries is felt by placing a finger in vagina (osiander sign)
Changes in cervix:
- 4th month- cervix becomes soft like lips (goodell’s sign)
Location of uterine fundus:
- 4th month- just above symphysis pubis.
- 5th month- midway b/w symphysis pubis & umbilicus.
- 6th month- umbilicus.
- 7th month- midway b/w umbilicus & xiphoid.
- 8th & early 9th month- at xiphoid process.
Classification of signs of pregnancy in living:
- Suppression of menstruation
- Morning sickness
- Sympathetic disturbances
- Breast changes
- Pigmentation of skin
- Vaginal changes
- Urinary disturbances
- Changes in abdomen
- Softening of lower segment and os
- Presence of cervical mucus plug
- Braxton Hick’s sign
- Uterine souffle
- Biological tests
C.Positive signs of prgnancy:
- Fetal movements (after 5th month,at 24 weeks )
- Recognition of fetal parts (by abdominal examination)
- Fetal heart sound (160 bpm at 5th month, 120bpm at term),heard between 18-20 wks for first time.
- Radiograph of fetus (can be taken after 4th month)
- Ultrasound-G.S seen by 6th week
-Spurious or phantom pregnancy
-Seen in women near menopause or those who are much desiring pregnancy
-All subjective symptoms of pregnancy including increase in abdominal size by abnormal fat deposition,or ascites occur
-even lady seen to have started labour like pains
Signs of prgenancy in Dead (on PM examination)
- Presence of an ovum or fetus
- Uterine changes
- Presence of corpus luteum in one of the ovaries
- Uterus thickened and enlarged
- Length, breadth, & weight are increased
- Chorionic villi are seen on microscopic examination
- -born after the death of father
MLI of pregnancy:
- To escape hard labor or punishment
- To avoid court attendance
- In cases of property
- In divorce cases
- Black mailing
- If a woman is charged of unchastity
Superfecundation-fertilisation of two ova which have been discharged by two separate acts of coitus commited at short intervals.
Superfoetation –fertilisation of second ovum in a woman who is already pregnant.
Signs of recent delivery in living
- General appearance- pale, exhausted & ill looking sunken eyes, slight increase in pulse and temperature.
- After pains – intermittent contractions of uterus for the first 4-5 days after delivery.
- Breasts- enlarged, contain colostrums, surface veins dilated & prominent, striae & Montgomery’s tubercle present
- Abdomen- flaccid, wrinkled, striae gravidarum present
- Fourchette- ruptured, posterior comissure destroyed
- Vulva- bruised, tender & gaping
- Vagina- lax, capacious, rugae begin to reappear about the third week
Uterus- enlarged, easily felt, palpate as a cricket ball
Soon after delivery- 2.5cm below umbilicus
10th day- on level with pelvic brim
2-3 weeks- returns to pelvic cavity
6 weeks- returns to normal size and position
Cervix- soft, patulous, may be lacerated. Internal os closes in first 24 hours, external os in two weeks.
Lochia- discharge from uterus and vagina for about 2-3 weeks.
- Has a peculiar disaggreable odor
- 1st 4-5 days- bright red with large clots- lochia rubra
- Next 4 days- serous and pale in color- lochia serosa
- After 9th day- yellowish grey or turbid- lochia alba until its final disappearance
- If the blood or urine gives positive pregnancy test, strong evidence that pregnancy has been terminated recently. (likely to disappear in a week or 10 days)
Signs of recent delivery in dead:
- Breast when cut open, may show milk
- Uterus flabby and enlarged
- Ovaries and fallopian tube congested, on section may show corpus luteum