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Purpose: Women sexual violence as a gynecological, social-criminological and gynecological problem has no declining trend in developing and developed countries, including in Croatia. Methods: From my own 23-year forensic-gynecological expertises practice, along with the results of legally completed examples of sexual abuses, as a contribution to this problem, which is also read from other works. Results: Of the cases of sexual abuses (n = 31) with a median age of 37 years, gynecological-forensic expertise proved and confirmed 67.7% of sexual abuses criminal cases with a significant problem of inadequate primary gynecological procedure, most often due to insufficient gynecological examination and medical documentation in high 64.5%, as well as late sexual abuses report in 51.6%. Of all cases of sexual abuses, 6 (19.4%) required primary surgical care due to bleeding and lacerations of the genitals, there were no reported cases of sexual abuses in pregnancy, and no deaths related to sexual abuses. The problems that can affect the forensic-gynecological evaluation of sexual abuses victims are: inadequate and insufficient primary medical documentation immediately after sexual abuses, late reports of sexual abuses, after several days, months and years in the reproductive age of women, with a late primary examination and an almost difficult to prove objective gynecological examination and inadequate education of gynecologists in primary examination. Conclusion: In conclusion, it should be mentioned that the mentioned medical problems can be solved by constant education of all professional medical participants, permanent court experts with experience, coordination and subordination of expert gynecological and forensic societies in cooperation with the state attorney's office, courts and police, and social service. [ABSTRACT FROM AUTHOR]

Background: Sexual Assault Treatment Units (SATUs) provide holistic care, frequently including forensic examination, for people who disclose sexual violence. Storage of forensic evidence without reporting to An Garda Síochána (AGS), the Irish national police service (Option 3), was introduced in August 2016. This allowed attendees time to decide whether they wanted to report to AGS, without the loss of all forensic evidence. Aims: This paper presents a retrospective analysis of all "Option 3" cases including their subsequent disclosures to AGS, at the Dublin SATU, between 1 Aug. 2016 and 30 Jul 2020. Methods: The contemporaneous medical charts of Option 3 cases were reviewed and anonymised data extracted from them. Results: During the study period, there were 1258 attendances to the Dublin SATU. Of these, 10% (n = 127/1258) were Option 3. Ninety-three percent (n = 118/127) were female and 7% (n = 9/127) were male. The mean age was 26. Seventy percent (89/127) indicated a sexual assault occurred and 30% (38/127) were unsure. Twenty percent (n = 25/127) subsequently reported the incident to AGS, 60% (n = 15/25) within 7 days, and 80% (n = 20/25) within 1 month. Eighty percent (n = 20/25) of these reported cases had their evidence retrieved by AGS for analysis. Three percent (n = 4/127) requested that their evidence kits be kept for an additional year. None of these patients reported over that following year, and their evidence was subsequently destroyed. Conclusion: In conclusion, the availability of Option 3 has afforded people the opportunity to access responsive SATU care including storage of forensic evidence which may have significant evidential value. This potentially provides further opportunities for comprehensive detection of a crime, even if reporting to AGS is delayed. [ABSTRACT FROM AUTHOR]

Despite the existence of patterns able to discriminate between consensual and non-consensual intercourse, the relevance of genital lesions in the corroboration of a legal rape complaint is currently under debate in many countries. The testimony of the physicians when assessing these lesions has been questioned in court due to several factors (e.g., a lack of comprehensive knowledge of lesions, wide spectrum of background area, among others). Therefore, it is relevant to provide automated tools to support the decision process in an objective manner. In this work, we evaluate the performance of state-of-the-art deep learning architectures for the forensic assessment of sexual assault. We propose a deep architecture and learning strategy to tackle the class imbalance on deep learning using ranking. The proposed methodologies achieved the best results when compared with handcrafted feature engineering and with other deep architectures. [ABSTRACT FROM AUTHOR]

Determining fetal death causes is a complex problem for the forensic pathologist. Beyond the medico-legal context, the expert must be able to evaluate the viability of the fetus at the time of death, to eliminate in-utero fetal death and to determine if the death is related to a fetal, a maternal, a placental cause, or simply related to obstetrical complications. The authors present the case of a 21-year-old woman who unexpectedly gave birth to a fetus during a party. As pregnancy was not acknowledged by the mother (regular menstrual cycles and use of hormonal contraception), no obstetrical check-up had been performed. She would have presented violent abdominal pain and expelled a mass in the toilet. The fetus body, enclosed in the amniotic pouch, and the placenta were found in the toilet. A forensic autopsy was performed jointly by a forensic pathologist and a specialist in fetal pathology. Histological, toxicological and genetic samples were collected. Body morphometry and bone maturation indicated a gestational age of 31–32 weeks of amenorrhea. A significant asphyxia syndrome and non-specific multi-visceral congestion were noted at autopsy. Histological analysis of the fetal tissues revealed a lung and skeletal muscle maturation in accordance with the estimated term. At the brain level, there were signs of anoxia and abnormal cortical development with periventricular nodular heterotopia areas. The placenta microscopic analysis revealed acute chorioamniotitis, the probable cause of the premature fetal expulsion. Toxicological analyses revealed the presence of ecstasy (48 ng/mL) and its metabolite MDA (2 ng/mL) in fetal blood. Although negative in blood, THC-COOH tested positive in urine (9 ng/mL). The fetus was repetitively exposed to cannabis, as Δ9-THC tested positive in hair (51 pg/mg). Maternal hair analysis on 4 × 3 cm evidenced a long-term use of cannabis, while results support single massive exposure to ecstasy. In this article, the authors try to explain the reflexive pathway carried out to establish death causes and the maternal toxic consumption imputability on the cerebral malformations and fetal death. This case illustrates both the interest of toxicological analyses in cases of fetal death and the importance of a collaborative work between forensic and fetal pathologists and toxicologists, which appeared critical to answer in the best conditions to the magistrates questions, as well as to the bereaved families. [ABSTRACT FROM AUTHOR]

The rising prevalence of women with opioid addiction in pregnancy necessitates understanding of medical, ethical, and legal considerations on the part of obstetricians. In addition to briefly reviewing the medical care of opioid abuse in pregnancy, we offer a careful consideration of the stigmatization of addiction and resultant medicolegal sequelae. We advocate for improved access to opioid maintenance therapy and social services as a means of improving healthful pregnancy outcomes and decry recent trends in the criminalization of addiction nationwide. [ABSTRACT FROM AUTHOR]

Objective. To assess the impact of the medical documentation and biological trace evidence in rape cases on the legal process. Design. Retrospective descriptive study. Setting and sample. Police-reported cases of rape of women ≥16 years old in the Norwegian county of Sør-Trøndelag from January 1997 to June 2003. Methods. Police data were merged with data from the Sexual Assault Center at St Olav's Hospital. Charged and non-charged cases were compared. Main Outcome Measures. Medico-legal findings and legal outcome. Results. A total of 185 police-reported cases were identified. Of the 101 cases examined at Sexual Assault Center, charges were filed in 18 cases. Extragenital injuries were documented in 49 women; five were life threatening. Anogenital injuries were documented in 14 women; eight had multiple anogenital injuries. Documentation of injuries was not associated with charge filing. In only 33% of the cases were swabs collected from women's genitals used as trace evidence by the police. When used, this increased the likelihood for charge filing. A DNA profile matching the suspect was identified in four of the 18 charged cases and in only one among the 54 non-charged cases. Conclusions. Half of the women had one or more documented injury. Only one-third of the trace evidence kits collected from the women's anogenital area were analyzed. The analysis of swabs was associated with charge filing, regardless of test results. Increased use of such medical evidence, especially in cases of stranger rape, may ensure women's rights and increase available information to the legal system. [ABSTRACT FROM AUTHOR]

We propose the use of an approach to evaluation that can be undertaken in a clinical setting when concerns regarding child sexual abuse are unclear or ambiguous and other systems are not involved, thus providing an option for the nondisclosing child often discussed in the 'delayed disclosure' literature. This approach can also be appropriate for a child with a questionable prior disclosure not being served by other intervention systems. We have labeled this an 'integrative' model, incorporating forensically sound practices into evaluations conducted in a clinical setting. The goals of this manuscript are to (a) provide a rationale for conducting child sexual abuse extended evaluations in a clinical setting, (b) delineate the purposes of such evaluations, (c) differentiate this 'integrative' model from the forensic-clinical dichotomy framework discussed by Kuehnle (1996), and (d) briefly describe the format, which can be refined by future practice and research. [ABSTRACT FROM AUTHOR]

The article discusses the court case S v. Rozani; Rozani v. Director of Public Prosecutions, Western Cape and others, wherein the appellant pleaded guilty to the charges of rape and attempted rape filed against him due to his misunderstanding of the term rape. Both the prosecutor and the defence attorney possess a copy of a J88 medico-legal form which indicates that the complainant is virginal with her hymen intact yet such document was not presented to the magistrate. The South African High Court held that a gross failure of justice occurred.

Sexual assault and rape have serious consequences regarding health and law with physical and psychological outcomes of the problem. Pregnancy after rape, potential delay of diagnosis, physical and psychological injuries that might ocur as a consequence necessitate a multidisciplinary work of the medicolegal and ethical aspects of the subject. A case of pregnancy after rape who was in the 20th week of gestation has been evaluated by the Departments of Forensic Medicine, Obstetrics and Gynecology and Physchiatry. Clinical aspects of this presented case with a diagnosis of "post traumatic stress disorder, major depression and epileptic psychosis" have been considered to support consistency of her pregnancy with alleged rape history. In the article, termination of pregnancy with respect to the amended Turkish Penal Code and other existing laws, principles of legal and medical approach by the specialists of the related branches of medicine to the cases of pregnancy after sexual assault and rape have been discussed. The well defined collaboration of clinicians with medicolegal experts in scope of clinical forensic medicine will guide any medical procedure for legitimization as well as to support judicial procedure by providing safeguards for collecting samples, and expected security of evidence needed. [ABSTRACT FROM AUTHOR]

Audit of the quality of gynaecological care is essential so that errors due to medical interventions can be reduced to the bare minimum. The aim of this study was to determine the incidence and nature of adverse gynaecological events. The clinical records of all women admitted with gynaecological conditions over 9 months were assessed for adverse events, defined as an injury caused by medical management rather than the underlying disease. Adverse events occurred in 11.7% of admissions and 52% were avoidable. The majority of adverse events were minor (disability lasting less than 6 months). Mortality accounted for 17.7% of adverse events and 2.1% of all admissions. The death rate was higher in the elective admissions. The frequency of adverse events increased with age, the presence of co-existing illnesses, and severity of the illness on admission. Therapeutic mishaps ( n = 67; 8%) were the most common type of adverse event. Lessons learnt from audit should reduce adverse events considerably. [ABSTRACT FROM AUTHOR]

In this exploratory study we examine the practices surrounding with respect to standardization the administration and processing of the Sexual Assault Evidence Kit (SAEK). Despite the presumed scientific objectivity of this protocol, our survey of sexual assault nurses, physicians, police, and forensic scientists found that discretionary practices pervaded the evidentiary process. We argue that there must be greater awareness of the shaping of medicolegal evidence. Given the diverse characteristics of sexual assaults and of the health care needs of sexually assaulted women, we also suggest that it may be unreasonable to apply a single standard model of a rape kit. [ABSTRACT FROM AUTHOR]

Studies depositions, reports and trial transcripts of four frequently testifying experts in obstetrics-gynecology. Purposes of expert testimony; Contradictions in claimed medical principles; Reliability and accuracy of expert testimony regarding the standard of care; Peer review or sanction process to ensure accuracy and reliability.

A lithopaedion, or stone-child, is a dead fetus, usually the result of a primary or secondary abdominal pregnancy, that has been retained by the mother and subsequently calcified. This paper describes the earliest known case of this phenomenon. It was discovered in 1582, at the autopsy of a 68-year-old woman in the French city of Sens, and described in a thesis by the physician Jean d'Ailleboust. The woman had carried her lithopaedion for 28 years. In this historical vignette, the lithopaedion of Sens is compared to later instances of this phenomenon. The ultimate fate of the lithopaedion specimen, which was widely traded throughout Europe in the 1600s before finally ending up in Copenhagen, is traced. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses the new column of the journal called Medico-legal cases.