Delivery





The signs of recent delivery are as follows: The face is pale, with dark

circles round the eyes; the pulse quickened; the skin soft, warm, and

covered with a peculiar sweat; the breasts full, tense, and knotty; the

abdomen distended, its integuments relaxed, with irregular light pink

streaks on the lower part. The labia and vagina show signs of distension

and injury. For the first three or four days there is a discharge from

the uterus more or less sanguineous in character, consisting of blood,

mucus, epithelium, and shreds of membrane. During the next four or five

days it becomes of a dirty green colour, and in a few days more of a

yellowish, milky, mucous character, continuing for two to three weeks.

The change in character of the lochial discharge is due to the quantity

of blood decreasing and its place being taken by fatty granules and

leucocytes. The os uteri is soft, patulous, and its edges are torn. The

uterus may be felt for two or three hours above the pubis as a hard

round ball, regaining its normal size in about eight weeks after

delivery. Most of these signs disappear about the tenth day, after which

it becomes impossible to fix the date of delivery.



In the dead the external parts have the same appearance as given above.

The uterus will vary in appearance according to the time elapsed since

delivery. If death occurred immediately after delivery, the uterus will

be wide open, about 9 or 10 inches long, with clots of blood inside, and

the inner surface lined by decidua.



The signs of a previous delivery consist in silvery streaks in the skin

of the abdomen, which, however, may be due to distension from other

causes; similar marks on the breast; circular and jagged condition of

the os uteri (the virgin os being oval and smooth); marks of rupture of

the perineum or fourchette; absence of the vaginal rugæ; dark-coloured

areola round the nipples, etc. The difference between the virgin corpus

luteum and that of recent pregnancy is not so marked as to justify a

confident use of it for medico-legal purposes.





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