Travma sonrası gebelik sonlanmasının adli tıbbi yönü

Öz

AMAÇ: Gebe kadınlar gebe olmayan kadınlarla benzer travma riskine sahip olmakla birlikte uğradıkları travmanın hem klinik hem de adli tıbbi sonuçları olabilmektedir. Bu çalışmada adli tıp pratiğinde karşılaşılan sorunlardan biri olan travma sonrası gebelik sonlanmasının adli boyutunun değerlendirilmesinde dikkate alınacak hususların ortaya konması amaçlanmıştır. GEREÇLER: Çalışmada 2005-2012 tarihleri arasında travma sonra gebelik sonlanması iddiası ile Adli Tıp Kurumu Adli Tıp İkinci İhtisas Kurulu’na gönderilen vakaların adli dosyalarında bulunan adli ve tıbbi belgelerde kayıtlı bulgulardan travma mağduru olduğu iddia edilen gebenin sosyodemografik özellikleri, tıbbi geçmişi, failin yakınlığı, travmanın türü, lokalizasyonu, travma ile semptom arasındaki süre, travma ile gebelik sonlanması arasındaki süre dikkate alınmıştır. Kurul sonucu ile bu sonuca gerekçe olarak gösterilen veriler değerlendirilmiştir. BULGULAR: Çalışmanın kapsadığı sekiz yıllık dönemde 158 olguya mütalaa düzenlenmiş olup olguların %60’ının 19-30 yaş aralığında olduğu görüldü. İddia olunan travma sonrası en sık gebelik sonlanmasının birinci trimesterde meydana geldiği ancak istatistiksel olarak anlamlı olacak şekilde birinci trimester gebelik sonlanmalarında nedensellik bağı kurulmadığı görülmüştür. Gebelik sonlanmasına neden olduğu iddia edilen travmalar arasında en sık abdominopelvik travma, karşılaşılan en sık semptomun da vajinal kanama olduğu belirlenmiştir. SONUÇ: Bu çalışma sonucunda travma ile gebelik sonlanması arasındaki nedensellik bağı değerlendirilirken en sık başvurulan ve araştırılan kriterlerin gebenin yaşı, gebelik dönemi, travma türü, lokalizasyonu, semptomların ortaya çıkış süresi olduğu, bunlardan gebelik dönemi ve semptomların ortaya çıkış zamanının daha belirleyici olduğu tespit edilmiştir.

Anahtar Kelimeler

• Gebelik sonlanması
• travma
• nedensellik bağı
• adli tıp

Forensic aspects of pregnancy termination after trauma

Öz

INTRODUCTION: Pregnant women have a similar risk of trauma as non-pregnant women, but their trauma can have both clinical and forensic medical consequences. In this study, the aim of this study was to reveal the issues to be taken into consideration in evaluating the forensic aspects of pregnancy termination after trauma, which is one of the problems encountered in forensic medical practice. METHODS: In this study, cases referred to the 2nd Specialization Board of the Council of Forensic Medicine unit between 2005 and 2012 with the claim of termination of pregnancy after trauma were evaluated. Among the findings recorded in forensic and medical documents, the sociodemographic characteristics of the pregnant victims, their medical history information, the relational degrees of the perpetrators, the types and localizations of the trauma, the time between trauma and symptoms, and the time between trauma and pregnancy termination were evaluated. The results of the Board and the data shown as justification for these results were evaluated. RESULTS: During the eight-year period covered by the study, 158 cases were considered, and 60% of those were of women between the ages of 19 and 30. It was observed that the most frequent pregnancy termination after trauma occurred in the first trimester, but causality was not established in first trimester pregnancy terminations. Among the traumas claimed to cause pregnancy termination, it was determined that the most common was abdominopelvic trauma, and the most common symptom was vaginal hemorrhage. CONCLUSION: The most frequently used and investigated criteria when evaluating the causality between trauma and pregnancy termination were the age of the pregnant woman, the gestational period, the type and localization of the trauma, and the onset of symptoms. The most determinant criteria were the gestational period and the time of onset of symptoms.

Anahtar Kelimeler

• Pregnancy termination
• trauma
• casuality
• forensic medicine

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