Pandemic central abortion

Abstract

Background: One of the phenomena that have begun to emerge amid the COVID-19 pandemic is an increase in unemployment. The Central Statistics Agency (BPS) reported that in February 2020 there were 6.88 million unemployed, an increase of around 60,000 people over the same period in 2019. The unemployment rate reached 4.99% of the total workforce of 137.91 million people. The government projects an increase in the unemployment rate due to the pandemic could reach 5.23 million people. Economic difficulties are closely related to work as a source of income. Various studies have linked economic hardship with conflicts at home and work, mental health, unhappiness, and even causes of various diseases that lead to death. Due to the COVID-19 pandemic, it is not known when it will end, which has a huge impact on the economy, including the medical profession which may cause thoughts of taking illegal actions such as abortion.

Case report: Reported a case of fetal abortion approximately eight weeks old at a clinic in Medan city. The victim was taken to the Pirngadi Hospital in Medan by the police along with a request for Visum et Repertum and an internal and external fetal examination was carried out right away.

Result: On external examination: There were bruises of the corpse on the back and back of the upper and lower limbs, did not disappear on emphasis. There were stiff corpses in the jaw joints, neck, fingers, and toes that were easy to resist. We found the umbilical cord was still attached to the abdomen and one with the complete placenta. There were bruises, almost all of the surface of the umbilical cord and upper left arm to the forearm. There was extensive blood infiltration, almost all of the outer surface of the placenta. Fingernails and toes had not grown past the fingertips. Brownish color in the cross-sections of the upper leg bones (femur) and lower leg bones (tibia), as well as the bones that form the soles of the feet (talus, cuboid, and calcaneus). The tips of the fingers and toes were pale. Internal Examination: There was blood infiltration in the left scalp on the back, the crest of the skull, the thick membrane of the right brain, the left chest across the midline of the body, and on the front of the heart. There was a blood clot under the thick membrane of the left and right brain. There was a soft brain. There was found the dividing membrane of the chest and abdominal cavity (diaphragm), as high as the second and third ribs. On the touch, the surface of the lungs feels rubbery. In the lung buoyancy test, both lungs sink (negative lung buoyancy test). At the opening of the gastric cavity, the stomach and intestines are empty.

Discussion: Based on the history of the investigators who went to the scene of the crime, the fetus was found in 4 layers of plastic bags at a clinic in Medan, which allegedly died as a result of being forced to remove it from its mother's womb by force or unnatural means. From the results of the provisional investigation that the clinician doctor who performed the abortion at the request of the fetus mother, who is currently a suspect who helped besides the main suspect is the fetus's mother, whose identity is not yet known.

Conclusion: The victim is a fetal corpse, unknown, male gender, body length 24 cm, body weight 650 grams, reddish-brown skin color, the umbilical cord is still intact on the stomach, and placenta, hair has not yet grown. It is estimated that the fetus is 19-26 weeks old (not yet viable), with blood infiltration found in the left scalp area on the back, the crest of the skull, the thick membrane of the right brain, the surface of the umbilical cord, the placenta, the left chest opposite the midline the body and front surface of the heart accompanied by a blood clot under the thick membrane of the left and right brain.