外伤与流产因果关系分析

Analysis of the Causality between Trauma and Abortion

目的研究外伤性流产法医学鉴定案件的特点,探讨如何利用临床资料,尤其是实验室检查结果(B超、血HCG变化等)对外伤性流产的认定及损伤程度的判定等问题。方法根据流产的原因、分类及妊娠生理变化等临床特点,结合案情特点、临床表现、既往史、实验室检验及辅助检查结果等进行因果关系分析。结果本组5例案件中4例为早期流产,1例为晚期流产,3例均因胚胎发育异常否认外伤性流产,1例因人为因素自行药物流产难以认定外伤性流产,1例认定为外伤性流产。结论外伤史明确的前提下,外伤性流产的认定可首先依据实验室检查结果分析胚胎(或胎儿)发育情况,若胚胎存在异常,一般可直接排除外伤性流产,如胚胎发育正常,可再根据其他临床资料进行分析评定。

The characteristics of traumatic abortion caeses in clinical forensic medicine is studied, and how to use the clinical data, especially the laboratory results （B scan, blood HCG, etc.） to ascertain the traumatic abortion is discussed. Five cases of post-traumatic abortion in recent years, including four premature abortion and one late abortion, were collected and ana- lyzed. Among the five cases, three were abnormal fetation, one was the drug abortion and one was traumatic abortion. With an ascertained history of trauma, the embryonic development could be analyzed from the laboratory results for the identification of traumatic abortion. If the fetation is abnormal, the existence of a direct causal relationship between trauma and abortion could be excluded. Otherwise, more clinical data are needed.