Which finding would most strongly prompt assessment for domestic abuse in a pregnant patient?

Which finding would most strongly prompt assessment for domestic abuse in a pregnant patient?

• A. Facial and abdominal bruises
• B. Nutritional deficiency
• C. Leg swelling
• D. Headache

Answer: (A)

Direct physical injuries are the strongest prompt to screen for domestic abuse. Bruising on the face and abdomen provides tangible, visible evidence of trauma that could be inflicted by a partner, which raises serious safety concerns for both the pregnant patient and the fetus. In prenatal care, this kind of injury should trigger a careful, confidential assessment for intimate partner violence, with attention to safety planning and appropriate referrals. Nutritional deficiency, while important to address in pregnancy, can arise from many non-abuse-related factors and doesn’t on its own indicate abuse. Leg swelling is a common, often benign finding in pregnancy (though it can signal other conditions), and headaches have multiple causes as well. None of these alone strongly point to domestic violence, whereas facial and abdominal bruises do.

Direct physical injuries are the strongest prompt to screen for domestic abuse. Bruising on the face and abdomen provides tangible, visible evidence of trauma that could be inflicted by a partner, which raises serious safety concerns for both the pregnant patient and the fetus. In prenatal care, this kind of injury should trigger a careful, confidential assessment for intimate partner violence, with attention to safety planning and appropriate referrals.

Nutritional deficiency, while important to address in pregnancy, can arise from many non-abuse-related factors and doesn’t on its own indicate abuse. Leg swelling is a common, often benign finding in pregnancy (though it can signal other conditions), and headaches have multiple causes as well. None of these alone strongly point to domestic violence, whereas facial and abdominal bruises do.