gynecology and obstetrics
Medical Examination of the Rape Victim
Key Points
Sexual assault is any type of sexual activity or contact that a person does not consent to. Nongenital or genital injury, sexually transmitted infections, and pregnancy may occur. In the short term, most patients experience fear, nightmares, sleep problems, anger, embarrassment, and other psychologic symptoms; although most patients eventually recover; some develop posttraumatic stress disorder (PTSD). Explain the benefits of a rape evaluation, which the patient can consent to or decline; ask the patient's permission before each step of the evaluation, and explain what each step involves and why it is being done. Check for injuries, test for pregnancy and sexually transmitted infections, collect evidence that can provide proof of rape (eg, smears of the buccal, vaginal, and rectal mucosa), and maintain chain of custody. Provide psychologic support for the patient and the patient's family, provide prophylaxis for sexually transmitted infections, and offer emergency contraception. 