Effectiveness of medical self-experience counseling in pregnant women after echocardiographic detection of a suspected fetal heart anomaly: A longitudinal study.
OBJECTIVE
The purpose of this longitudinal study was to assess maternal psychological responses after echocardiographic detection of a suspected fetal heart anomaly and to evaluate a medical self-experience counseling intervention in improving psychological responses.


METHODS
A total of 751 women were referred to Shandong Provincial Hospital, Jinan during May 2014 and April 2015. To analyze the psychological impact on the mothers, the groups were divided into mild, intermediate and severe, according to heart defect severity. State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory II (BDI-II) questionnaires were distributed in three steps: first evaluation, after the diagnostic examination; second evaluation, two weeks after step one, both study and control groups underwent routine psychological counseling; third evaluation, two weeks after step two, study groups underwent self-experience counseling and controls underwent routine counseling. Anxiety and depression scores and above clinical cut-off percentages in the subgroups were calculated and compared.


RESULTS
The severity of anxiety and depression was not significantly relieved with the alleviative type of suspicious heart abnormality. State-STAI and BDI-II scores and above clinical cut-off percentages were statistically different between steps 2 and 3 in intermediate and mild mothers. Women in control groups did not exhibit obvious relief of anxiety and depression.


CONCLUSIONS
Women pregnant with fetuses with mild or intermediate fetal heart abnormalities presented heightened levels of depression and anxiety when compared with mothers pregnant with fetuses with severe heart disease. Medical self-experience counseling played an important role in relieving anxiety and depression in these mothers.
Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Mei
M
Zhu
Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Hao
H
Liang
Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China. juanjuanquyu@126.com.
Juan
J
Feng
Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Zhengjun
Z
Wang
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Wei
W
Wang
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Yanhui
Y
Zhou
D001007:Anxiety / Q000628:therapy; D003863:Depression / Q000628:therapy; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000523:psychology*
anxiety; depression; echocardiography; fetal heart; prenatal diagnosis