The aim of this study was to evaluate and elucidate the impact of intimate partner violence (IPV) on women's reproductive health and pregnancy outcomes taking into account data from various countries. The search of the literature was made in MEDLINE database service for the years 2002-2008. Original articles, reviews, surveys, clinical trials and investigations pertinent to the theme were considered for this review. The lifetime physical or sexual IPV or both varied from 15% to 71% in many countries. Adolescent violence, negative emotionality and quality of the relationship with the intimate partner were associated with genesis of IPV, besides demographic, social and structural difference in attitudes. IPV affected woman's physical and mental health, reduced sexual autonomy, increased risk for unintended pregnancy and multiple abortions. Risk for sexual assault decreased by 59% or 70% for women contacting the police or applying for a protection order, respectively. Quality of life of IPV victims was found significantly impaired. Women battered by IPV reported high levels of anxiety and depression that often led to alcohol and drug abuse. Violence on pregnant women significantly increased risk for low birth weight infants, pre-term delivery and neonatal death and also affected breast-feeding postpartum. Women preferred an active role to be played by healthcare providers in response to IPV disclosure. Gynaecologists reported interventions for the patient disclosing IPV and provided treatment for their physical and emotional complaints. Educating and empowering women and upgrading their socioeconomic status may abate the incidence of IPV. Women should also seek protection against IPV.
Their cost evidently poses a barrier to the use of condoms by the poor. Beside social stigmas and personal reluctance, prevailing moral norms and religious interdicts also adversely affect use of these devices in many communities. Because of their disastrous consequences in the domain of public health each of these barriers must be effectively addressed.
Systemic infection in the newborn is the commonest cause of neonatal mortality. Data from National Neonatal Perinatal Database 2000 suggest that Klebsiella pneumoniae and Staphylococcus aureus are the commonest causes of neonatal sepsis in India. Two forms of clinical presentations have been identified. Early onset sepsis, probably related to perinatal risk factors, usually presents with respiratory distress and pneumonia whthin 72 hours of age. Late onset sepsis, related to hospital acquired infections, usually presents with septicemia and pneumonia after 72 hours of age. Clinical features of sepsis are non-specific in neonates and a high index of suspicion is required for the timely diagnosis of sepsis. Although blood culture is the gold standard for the diagnosis of sepsis, reports are available after 48-72 hours. A practical septic screen for the diagnosis of sepsis has been described and some suggestions for antibiotic use have been included in the protocols.
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