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    Clinical Cues/Health Impact of IPV

    Be alert to patient/partner behavior(s) that may be an indication of an abusive relationship
    • Patient missing appointments and/or not following up 
    • Partner always accompanies patient to appointments, speaking for her, interrupting her, hovering.
    Even if a patient answers “No” to screening questions, there may be clinical cues that alert you to explore the issue further.
    • Current or past IPV can result in acute injuries, behavioral health problems, and chronic medical disorders as shown in the following table:


    IPV: Associations with Health

    Physical Injuries
    -Bruises and petechia, lacerations, fractures, bites - (especially to head, neck, face [eyes, cheeks, lips, nose], arms, and breasts) and abdomen when pregnant
      -strangulation, loose or broken teeth
    -Death (homicide)
    Mental Health
    -Post Traumatic Stress Disorder (PTSD)
    -Eating disorders
    -Panic attacks
    -Death (suicide)
    Substance Abuse
    -Alcohol and illicit drug abuse
    -Cigarette smoking
    -Tranquilizer and sleeping pill abuse
    Chronic Disorders
    -Chronic pain syndromes
    -Headaches, migraines
    -Hearing loss
    -Temporo-mandibular disorders
    -Cardiovascular disorders
    -Gastrointestinal disorders (irritable bowel syndrome, indigestion, spastic colon, ulcers)
    Reproductive Health
    -Unintended pregnancy
    -Pelvic pain, dysmenorrheal, dyspareunia
    -Urinary tract infections
    -Pelvic inflammatory disease
    -Sexually transmitted infections (STI) and HIV
    -Abnormal cervical cancer screening tests (Pap)
    -Non-viable pregnancies (miscarriage, abortion, stillbirth)
    -Poor prenatal behaviors (late or no prenatal care, poor nutrition, smoking)
    -Poor pregnancy outcomes (prematurity)