Background and Aim: In Asian countries, child bearing is a social obligation. Experience of infertility profoundly affects the personal well-being of women. Women with infertility are at a higher risk of anxiety, depression, and Intimate partner violence (IPV). In this background the present study was carried out to determine IPV and psychiatric comorbidity in women with infertility. Methods: Hundred consecutive women with primary infertility in the age group of 18 years to 45 years were included in the study. Psychiatric diagnosis was made according to DSM-5. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used to assess the severity of the anxiety and depressive symptoms. IPV was assessed using WHO violence against women instrument. Results: The mean age of the 100 women was 26.73 ± 4.23 years, duration of marriage was 7.11 ± 4.177 years and duration of infertility treatment in years was 5.56 ± 3.89. The prevalence of IPV among patients was 50% and psychiatric comorbidity was 46%. When we compared the women who experienced IPV and who did not, the prevalence of anxiety disorder and depressive disorder was high among IPV group. Anxiety, depressive scores in HAM A, HAM D were higher in IPV group compared to the other group and was statistically significant. Conclusion: A significant number of women who had infertility reported IPV. This emphasizes the importance of screening for IPV in these women. It is observed that women with IPV had higher psychiatric comorbidity and may require psychotherapeutic intervention.

Aim of the studyTo assess Intimate partner violence and psychiatric co-morbidities in pregnant women.Subject or material and methodsHundred and twenty consecutive patients who were pregnant attending the Ante natal clinic between 18-45 years were included in study. They were administered a semi structured proforma to collect socio demographic details, Intimate Partner Violence (IPV) was assessed by WHO violence against women instrument. Psychiatric diagnosis was made according to Diagnostic and Statistical Manual-5 criteria (DSM-5), anxiety was assessed using Hamilton Anxiety Rating scale (HAM-A), depression was assessed using Hamilton Depression Rating Scale (HAM-D).ResultsAbout 15% of the patients had psychiatric comorbidities and 35% of the patients had history of intimate partner violence. Eighteen (42.85%) of the 42 had psychological violence and 24(57.15%) had physical sexual violence. When we compared the females, who did not have IPV (group 1) and who had IPV (group 2)- suicidal ideas, MTPs more than one, stress, depressive disorder and anxiety disorder was more in group 2 and this difference was statistically significant. Substance abuse was observed more in group 2 spouses than group 1 spouses and was statistically significant.DiscussionIPV and psychiatric morbidity has been observed significantly during pregnancy and antenatal care presents a unique opportunity in which health care providers can foster trusting relationships with pregnant women, thereby increasing the likelihood of IPV detection and mitigating its related negative consequences to both mother and child.ConclusionsA significant number of pregnant women reported IPV. This emphasizes the importance of screening for IPV in these women.

We present a rare case of A2+ve blood group with Placenta praevia with Obstetric Haemorrhage in mild hypovolemic shock. An emergency request for blood transfusion confounded the blood bank officer as the patient's blood was seemingly incompatible with all ABO blood groups. Further investigation revealed the patient's blood group to be a rare subtype of the A group known as A2+ve. This article highlights the need to be aware of such rare subgroups, especially in tertiary referral centres like ours, where unbooked Obstetric emergencies are encountered on a regular basis, so life-saving measures can be appropriately taken. CASe RepoRTA 31-year-old unbooked lady presented to the Obstetric emergency ward and a diagnosis of gravida 2, para 1, living 0 with 27 weeks of gestation with central placenta praevia with ante partum haemorrhage was made. She had undergone a previous caesarean section at term for a transverse lie and the baby was still-born. Patient had been treated for secondary infertility and conceived spontaneously ten years later with the present pregnancy. General examination revealed the patient to be in mild hypovolemic shock with a tachycardia of >130 beats/minute. Her blood pressure was 94/60 mmHg. Haemoglobin was 8.4 gm/dL. Blood group was A+ve but when sent for cross matching was found to be incompatible with all ABO groups. Senior blood bank officers were called in and further tests done indicated a rare subgroup of A2+ve. No blood in our bank and two other major blood banks was found compatible. Ultimately, four pints of compatible A2+ve blood was found after screening nearly 600 pints of A+ve blood at the Karnataka Red Cross Blood Bank. At present patient has received 3 pints of blood and antenatal steroids. Since she has no further bleeding we plan to monitor her as an inpatient till she crosses her period of viability or the fetus can sustain in an extra uterine environment, provided she has no further life threatening haemorrhage which would compromise either her or the baby. DiSCuSSionMassive obstetric haemorrhage is a major contributor towards maternal morbidity and mortality. The main causes are abruptio placentae, placenta praevia and postpartum haemorrhage [1]. Clinicians managing pregnant women should be equipped with the knowledge of blood and blood products and skills for managing massive obstetric haemorrhage. We are all familiar with the blood groups O, A, B discovered by K Landsteiner in 1900, by performing a series of mixing experiments with the blood of 22 colleagues in which red cells from each individual was mixed with the serum of each of the others. On the basis of the agglutination pattern that he observed, Landsteiner could establish three groups of individuals (A, B and O). Two years later, Landsteiner recognised a fourth (AB) group when the experiment was repeated on a larger group of subjects. Most clinicians are, however, unfamiliar with the fact that in 1911, Landsteiner detected the presence of subgroups of A, one of which was exhibiting weaker expression of th...

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