title: The effects of maternal anxiety prior to amniocentesis on uterine and fetal umbilical blood flow.
abstract: OBJECTIVE
  To investigate the mothers' anxiety levels and determine its effect on fetomaternal circulation in pregnant women undergoing genetic amniocentesis.
  
  
  METHODS
  A prospective case-control study was conducted regarding the assessment of maternal anxiety levels by means of the 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
  The maternal anxiety state 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 which elapsed from offering amniocentesis until it was 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 anxiety state 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 the amniocentesis procedure (β=1.44, p=0.02) and the time which elapsed in days from offering amniocentesis or ultrasonography up to its performance (β=0.41, p=0.04) increased the S/D ratio measured after the procedures.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Calışkan
authors.affiliation: Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey.
authors.forename: Sebiha
authors.initials: S
authors.lastname: Ozkan
authors.affiliation: Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey.
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Cakıroğlu
authors.affiliation: Department of Psychiatry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ozden
authors.initials: O
authors.lastname: Yalçınkaya
authors.affiliation: Department of Psychiatry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Aslıhan
authors.initials: A
authors.lastname: Polat
authors.affiliation: Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Corakçı
keywords: Doppler ultrasonography; Maternal anxiety; genetic amniocentesis