Sexual assault and rape

Abstract

Obstetricians and gynaecologists are not generally experienced in the field of sexual assault and rape. With increased rates of reporting rape, it is essential that gynaecologists have a working knowledge of the appropriate actions to take if a patient presents following an alleged rape. A non-judgemental, sensitive approach to the patient is essential. Early involvement of the police and a forensic medical examiner is optimal if the patient agrees. A comprehensive history with reference to a check list avoids missing essential information which may be required at a later date. Consent should be taken prior to examination and the patient given control to stop the consultation at any stage. A forensic medical examination is optimal. If this is declined, attention must be given to careful documentation of the examination findings. Again, prior reference to a check list is advisable. Any specimens should be kept in the possession of the examining doctor until forensic advice has been sought regarding their transit to the laboratories. Urgent surgical management must take priority over contacting the ‘expert’ or collection of forensic evidence. Medical management must give consideration to drug-assisted assault, sexually transmitted infections and pregnancy. Ongoing psychological support must be offered.