Uterine scar rupture at the site of the placenta accreta presenting as a case of sudden death

Uterine rupture during pregnancy is a known complication of placenta accreta. This paper presents a case of sudden maternal death in the 27th week of gestation due to a ruptured uterine scar at the site of placenta accreta with a short inter-pregnancy period of 6 months with previous two C-sections. Autopsy findings revealed a massive hemoperitoneum and a thinned out anterolateral uterine wall. Internal examination revealed clotted and fluid blood in the peritoneal cavity with rupture of the anterior uterine wall at the site of the placenta accreta in a healed cesarean section scar. Placenta accreta is a rare complication of pregnancy. However, it is becoming more frequent and a significant risk factor with the increasing rate of C-section.

Elephant Trample: A Two Year Study in RIMS, Ranchi

Introduction: Conflict between human and animals hasrisen from the time human have encroached their area.Animal attacks cases has arisen due to high urbanizationand increasing developmental pressure on forest habitats.Elephant often venture into human inhabitated areas attackingpeople, damage houses and destroy standing crops. The mainpurpose of the study was to assess the magnitude of the casesin the region.Material and Methods: The present study was conductedin the Department of Forensic Medicine and Toxicology,Rajendra Institute of Medical Sciences, Ranchi, Jharkhandfrom January 2013 to December 2014. During this period,2854 medico-legal autopsies were conducted out of which 21autopsy cases were of elephant trample. The relatives of thevictim and accompanying police were interviewed to obtainthe information regarding the incident.Results: The study revealed that males (81%) were mostlyaffected. The most affected age group is of 41-50 age groups(42.8%). All of them belong to the rural area and 28.6%incidences occurred in December. 95.2% victims died on thespot and 52.4% of the victims died of combined effect of headinjury and hemorrhagic shock.Conclusion: The study provides the valuable data regardingthe deaths by elephants. It also emphasizes to respect theterritory between humans and animals.