Clinical Correlates of Pain and Anxiety in Prenatal Diagnostic Procedures

Dadhwal, Vatsla; Sharma, Aparna; Singh, Aprajita; Deka, Deepika; Mittal, Suneeta; Kumar, Guresh

doi:10.1159/000337368

Cited by 5 publications

(12 citation statements)

References 18 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data from the literature8–18 and from this study demonstrate that prenatal diagnosis may induce concerns about a potential abnormal result. Women undergoing CVS experienced more stress and anxiety than women undergoing AC.…”

Section: Discussionmentioning

confidence: 68%

“…In general, these invasive diagnostic procedures are well tolerated by the patients. Nevertheless, various studies demonstrate that CVS and AC induce anxiety and that women undergoing prenatal invasive procedures often report anxiety and pain 5,8–18. Investigations on this matter confirmed that the pain experienced was actually much less than expected 9,10,14,18…”

Section: Discussionmentioning

confidence: 97%

“…Results have indicated that CVS and AC are associated with discomfort, tolerable levels of pain, or are nearly painless. In addition, a positive correlation was demonstrated between women’s levels of anxiety and the intensity of their pain experience 8–18…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Maternal anxiety and its correlation with pain experience during chorion villus sampling and amniocentesis

Klages¹,

Kundu²,

Erlenwein

et al. 2017

JPR

View full text Add to dashboard Cite

PurposeInvasive prenatal diagnostic procedures, such as chorion villus sampling (CVS) and amniocentesis (AC), are routinely performed to exclude or diagnose fetal chromosomal abnormalities. The aim of this study was to investigate anxiety-dependent pain experience during CVS and AC and the potential factors that increase anxiety and pain levels.Patients and methodsDuring a 2-year period, women undergoing invasive procedures in three specialist centers were asked to participate in the study. Anxiety was evaluated before the procedure using the Spielberger State-Trait-Anxiety-Inventory, and pain was evaluated directly after the procedure using a verbal rating scale.ResultsAmong the women, 348/480 (73%) underwent AC, while 131/480 (27%) underwent CVS. There was a significant correlation between state and trait anxiety (p<0.0001). A positive correlation existed between the degree of anxiety and the level of pain experienced (p=0.01). There was a positive correlation for trait anxiety (p=0.0283) as well as for state anxiety (p=0.0001) and pain perception (p=0.0061) when invasive procedure was performed owing to abnormal ultrasound finding or to a history of fetal aneuploidy. Maternal age was found to be another influencing factor for the experienced pain (p=0.0016). Furthermore, the analysis showed a significant negative correlation between maternal age and anxiety. That applies for trait anxiety (p=0.0001) as well as for state anxiety (p=0.0001). The older the woman, the less anxious the reported feeling was in both groups. The main indication for undergoing CVS was abnormal ultrasound results (45%), and the main reason for undergoing AC was maternal age (58%).ConclusionProcedure-related pain intensity is highly dependent on the degree of anxiety before the invasive procedure. In addition, the indication has a significant impact on the emerging anxiety and consequential pain experiences. These influencing factors should therefore be considered during counseling and performance.

show abstract

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Maternal anxiety and its correlation with pain experience during chorion villus sampling and amniocentesis

Klages¹,

Kundu²,

Erlenwein

et al. 2017

JPR

View full text Add to dashboard Cite

show abstract

“…Mean pain scores progressed with the same pattern between N 2 O and local anesthesia groups, namely, there was an increase in mean pain score during CVS, followed by a decrease 30-60 minutes after CVS ( Figure 3). [4][5][6]27,28 Pregnancy is a particularly emotional condition influencing anxiety. Notably, a closer look at the progression of mean anxiety scores during and 30-60 minutes after CVS highlighted the fact that in N 2 O group, anxiety scores decreased during and after CVS ( Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Managing pain and anxiety during transabdominal chorionic villus sampling. A noninferiority randomized trial of nitrous oxide vs local anesthesia

Katsogiannou

Donato

Loundou

et al. 2018

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction: Transabdominal chorionic villus sampling (CVS) is an invasive proce-dure for prenatal diagnosis reported to be associated with anxiety and pain. In this context, the need for analgesia during CVS has been considered useful. Even though several authors have been interested in pain management during amniocentesis, no study has been published on pain reduction during CVS. Our objective was to evaluate pain and anxiety management during transabdominal CVS using nitrous oxide (N 2 O) and local anesthesia. Material and methods:In a randomized controlled noninferiority trial, self-administered nitrous oxide (N 2 O) inhalation (equimolar premix of oxygen and nitrous oxide) was compared with local anesthesia (1% lidocaine) before CVS. Primary outcome was pain and secondary outcome was anxiety, both measured on a visual analog scale 30-60 minutes before, immediately after (5-10 minutes) and 30-60 minutes after CVS. With a statistical power of 90%, type I error of 5% and two-sided test and potential exclusions, a sample size of 96 patients per group was enrolled and randomized. No patient was enrolled before the trial registration date.

show abstract

“…In routine practice, an anesthetic agent is not used for the procedure because the pain is usually mild and brief, which most patients can easily tolerate. However, this pain during the procedure can cause discomfort and anxiety to some patients . Several studies have evaluated various methods to decrease pain during amniocentesis procedure using oral paracetamol, cryoanalgesia, music listening, and Xylocaine as anesthetic agent .…”

Section: Introductionmentioning

confidence: 99%

Effect of Xylocaine spray for analgesia during amniocentesis: a randomized controlled trial

2019

View full text Add to dashboard Cite

Objective To compare the effect of Xylocaine spray on pain score during amniocentesis Methods Singleton pregnant women undergoing amniocentesis were recruited. Each participant was randomly assigned into three groups. Group 1 (Xylocaine spray): 1 min before the procedure, 8 puffs (80 mg) of 10% Lidocaine spray were sprayed on abdominal wall: group 2 (placebo): 8 puffs of sterile normal saline were sprayed: and group 3 (control): no spray was used. The participants rated their pain through a 10‐cm visual analog scale before, during, and 30 min after amniocentesis. Main outcome of study was difference in pain score among three groups. Results A total 570 pregnant women participated; 191 in the Xylocaine group, 193 in placebo group, and 186 in control group. Baseline pain was not different. The median procedural pain score was significantly different (2.3, 3.3, and 2.8 respectively; p 0.001). Post‐hoc analysis showed that the procedural pain score in Xylocaine group was significantly lower than placebo or control group (p value <0.001 and 0.02, respectively). However, the pain score 30 min after procedure was not different. Conclusion Xylocaine spray can significantly decrease pain during amniocentesis, however, the clinical significance is unclear given that the procedure‐related discomfort is mild and short‐lived.

show abstract

Clinical Correlates of Pain and Anxiety in Prenatal Diagnostic Procedures

Cited by 5 publications

References 18 publications

Maternal anxiety and its correlation with pain experience during chorion villus sampling and amniocentesis

Maternal anxiety and its correlation with pain experience during chorion villus sampling and amniocentesis

Managing pain and anxiety during transabdominal chorionic villus sampling. A noninferiority randomized trial of nitrous oxide vs local anesthesia

Effect of Xylocaine spray for analgesia during amniocentesis: a randomized controlled trial

Contact Info

Product

Resources

About