Adherence to behavioural intervention in RCT study by the women experiencing domestic violence and attending ANC in a public hospital in India-an analysis.

Background: The paper aims to identify the factors for effective implementation and adherence to the behavioural intervention package by women experiencing domestic violence (DV) and attending ANC in a public hospital. Methods: A qualitative study was undertaken with 211 pregnant women experiencing DV and attending antenatal care (ANC) at the LN Hospital, New Delhi. The intervention was given to women recruited under the RCT study. The narratives were analysed under two broad themes, impeding and facilitating factors, with nine sub-themes. Findings: Impeding factors are external factors generated by the structural interaction of the participants, whereas facilitating factors are supplied internally in the trial to eliminate the influence of impeding factors and singulate the factors under study. Our results show that despite the plethora of impeding factors (nine), the overall sum impact of impeding factors falls short of the positive impact of facilitating factors (nine), which were minor adjustments but reinforce participation in the trial and adherence with 97% follow-up rates. Interpretation: Our study findings are expected to reset the treatment protocol, which entails converting impeding factors into facilitating factors for appropriate adherence and compliance and adequate access and utilization of public services. The sensitization of healthcare providers to the impact of the quality of human interaction on the patient and its impact on the uptake of healthcare services and adherence is needed, particularly in the public hospitals of India. Funding: Funds received for the research are from the Indian Council of Medical Research (ICMR), New Delhi, Government of India.

Domestic Violence during pregnancy as risk factors for stress and depression: The experience of women attending ANC at atertiary care hospital in India.

Domestic Violence (DV) during the antenatal period has major effects on the mother and pregnancy outcome and is associated with stress and mental health problems. The paper aims to examine the association of DV with stress and depression (S&D) during the first trimester of pregnancy attending antenatal care (ANC) at the Lok Nayak (LN) hospital, a tertiary healthcare hospital in New Delhi, India and address the response of the women. A mixed method was used to gain an in-depth understanding of the participants. A total of 921 women were screened from November 2018 to March 2020 using standard tools for the presence of incidents of DV and S&D. 517 pregnant women with up to 20 weeks of pregnancy who met the inclusion criteria and came to receive ANC at the facility were considered. The prevalence of DV in various forms (psychological, physical and sexual) during pregnancy (49.5%), stress (82%), and depression (33%) have an association that reflects the importance of acknowledging both of them as having a significant implication for the health of pregnant women in India. Analysis suggest that women who experienced DV during pregnancy are 4.9 times and 5.3 times more likely to suffer from stress and depressive symptoms than non-victims of DV respectively. The strong association reinforces the need to conduct routine screening during pregnancy to identify and respond to women with DV and S&D.

The Relationship Between Uterine Artery two-dimensional Color Doppler Measurement and Pregnancy Outcome: A Prospective Observational Study.

BACKGROUND: The purpose of the study was to evaluate the role of uterine blood flow parameters measured by uterine artery two-dimensional (2D)-power color doppler (PCD) ultrasound in predicting fertility outcomes in women undergoing IVF-ET cycles. METHODS: In this prospective observational study, a total of 188 infertile women who underwent IVF-ET cycles were investigated. Uterine artery 2D-PD measurements were taken during early follicular phase and on day of trigger. Pulsatility Index (PI), Resistant Index (RI), Peak Systolic Velocity (PSV), and Systolic/Diastolic ratio (S/D) were measured. Statistical correlation was sought between the doppler parameters and fertility outcomes. RESULTS: The pregnancy rate was 40.43% (76/188). The women who conceived (n= 76) (Group A) were found to have mean age of 31.2±3.9 years whereas the non-pregnant group of women (n=112) (Group B) had mean age of 31.45±4.25 years. The mean PI measurements subsequently during early follicular phase and on the day of hCG trigger between group A and group B were comparable (2.09±1.15 versus 1.9±0.95; p=0.385 and 1.86±1.12 versus 2.03±1.0; p=0.192, respectively). No significant changes in the uterine artery PSV values and S/D values and RI were noted during the cycle. CONCLUSION: Uterine artery doppler evaluation in women undergoing IVF cycles was not predictive of the pregnancy outcomes.