title: A Study on Unsafe Abortion Presented for Medicolegal Examination: Medicolegal Evidence and Limitations in Opinion.
abstract: BACKGROUND
  Unsafe abortion is a major health problem causing women's health at risk. It is the third leading cause of maternal mortality in Sri Lanka during the last decade. Strong evidence for administration of justice and thereby to improve the health care and policies regarding such victims is the expected aim of medicolegal examination.
  
  
  OBJECTIVE
  The aims of the study were to determine the pattern of unsafe abortions in medicolegally referred cases and to assess the strengths and the limitations of medicolegal opinion in such cases.
  
  
  METHODS
  Retrospective descriptive study was done based on the notes of the medicolegal examinations performed by the authors, on women who underwent illegal abortions during past 5 years.
  
  
  RESULTS
  Of 51 cases reviewed, mechanical interference was the method used in 45% of cases. Sixty-eight percent of the women were admitted to hospital with heavy bleeding. The condition on admission was critical requiring medical interventions to save the life in 53% of cases. Referral for medicolegal examination had been performed after 3 days of admission in the majority (59%) of cases, whereas in 47% of cases, there was a therapeutic interference within 3 days of medicolegal examination. At the time of medicolegal examination, evidence of initial interference could not be identified in majority (84%).
  
  
  CONCLUSIONS
  Provision of strong evidence to give expected legal outcome in cases of illegal abortion is limited. Judiciary and law enforcement authorities should be aware of these limitations and look for strong corroborative evidence to implement the penalty.
authors.affiliation: From the Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
authors.forename: Indira Deepthi
authors.initials: ID
authors.lastname: Kitulwatte
authors.forename: Anuruddhi Samanthika
authors.initials: AS
authors.lastname: Edirisinge
mesh_terms: D000024:Abortion, Illegal / Q000009:adverse effects / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D000027:Abortion, Incomplete / Q000628:therapy; D000293:Adolescent; D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D012189:Retrospective Studies; D013188:Sri Lanka / Q000453:epidemiology; D055815:Young Adult