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
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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.