Vaginal bleeding and abuse: assessing pregnant women in the emergency department.
OBJECTIVE
This study was done to determine the prevalence of physical abuse among an ethnically stratified group of pregnant women experiencing vaginal bleeding.


METHODS
The design of this study was a cross-sectional survey using two screening tools: the Abuse Assessment Screen (AAS) and the Danger Assessment (DA).


METHODS
The study sample consisted of 261 African-American, Hispanic, and Anglo pregnant women seen for vaginal bleeding in private and public emergency departments in a large (more than 2,000,000 people) metropolitan area.


METHODS
All women with vaginal bleeding were interviewed in a private examination room. With the help of an interviewer, each subject completed both screening tools and was later offered information about abuse as well as community resources. Each woman's pregnancy status was validated with either a urine pregnancy test or a serum beta human chorionic gonadotropin, and her discharge diagnosis was obtained from the emergency department record.


METHODS
Of the 261 pregnant women interviewed, 87 (33.3 percent) reported abuse, that is, 26.7 percent of the African-American women, 25.2 percent of the Hispanic women, and 58.3 percent of the Anglo women. Overall, Anglo women reported significantly more abuse (X2 = 21.96; df = 2; p < .00002) than non-Anglo women. We found no significant differences in reported abuse among the diagnostic groups. Abused and nonabused women significantly (p < .0005) differed on their DA scores (2.89 vs .55, respectively), but these scores were not significantly different among ethnicities.


CONCLUSIONS
Abuse of pregnant women reporting to emergency departments is common and can be detected readily with a two-question, five-minute screen. Once an abused woman is identified, a danger assessment screen can further identify whether she is at high risk for escalating violence in her home.
Greenberg
E M
EM
Texas Woman's University, Houston, USA.
McFarlane
J
J
Watson
M G
MG
D000293:Adolescent; D000328:Adult; D018585:Battered Women / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004630:Emergencies; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000453:epidemiology