Objective:

To investigate the mothers’ anxiety levels and to determine its effect on fetomaternal circulation in pregnant women undergoing genetic amniocentesis.

Materials and Methods:

A prospective case-control study was conducted regarding the assessment of maternal anxiety levels by means of Spielberger State-Trait Anxiety Inventory in 60 pregnant women having genetic amniocentesis and 60 control cases having their early second trimester ultrasonographic screening, 30 minutes before and immediately after the procedure. Additionally maternal-fetal hemodynamic changes and Doppler ultrasonographic measurements of fetoplacental circulation were recorded in both groups.

Results:

Mothers state anxiety scores were found to be significantly higher in the amniocentesis group (p<0.001). Maternal heart rate was significantly higher in the amniocentesis group (p<0.05), while the fetal heart rate was significantly lower (p<0.05) compared to the control group. Uterine artery Doppler measurements were comparable in the two groups but umbilical artery resistance index (p<0.05) and S/D ratio (p<0.05) were significantly higher in the amniocentesis group. Regression analysis revealed that the time elapsed from offering amniocentesis until performed is the main predictor of fetal umbilical artery S/D ratio measured prior to amniocentesis in the amniocentesis group (β=0.66, p<0.001) and maternal state anxiety scores (β=0.04, p=0.003) are the main predictors of fetal umbilical artery S/D ratio measured prior to amniocentesis or ultrasonography in the two groups. The education of the patient in years decreased (β= -0.13, p=0.04), while amniocentesis procedure (β=1.44, p=0.02) and the time elapsed in days from offering amniocentesis or ultrasonography until performed (β=0.41, p=0.04) increased the S/D ratio measured after the procedures.

Discussion:

Our study provides the evidence that maternal anxiety and its duration has effects on the fetal blood flow. Early booking and patient support may help to overcome undesired consequences of an invasive prenatal procedure.

Keywords: Maternal anxiety, genetic amniocentesis, Doppler ultrasonography