Women's knowledge, concerns and psychological reactions before undergoing an invasive procedure for prenatal karyotyping.

Objectives: To evaluate women's reasons for having an invasive procedure, their knowledge, how information was obtained, their satisfaction with this information, their concerns about complications and psychological reactions and distress evoked by the procedure.

Methods: Ninety-four pregnant women undergoing early amniocentesis or chorionic villus sampling (CVS) at 10-13 weeks' gestation participated in a questionnaire study. The women could choose between early amniocentesis (n = 38) and CVS (n = 31), or to be randomized to either of them (n = 25).

Results: Apart from two items, no differences were found between the groups. Age was the main reason for testing, and anxiety was stated as a reason by 38.3%. The women knew more about methods for fetal karyotyping, what the tests can reveal and how they are performed, than about the risks and reliability of the tests. The main source of information had been doctors and midwives at the antenatal care center. For a majority of women (64.9%) the decision to have the test was made together with their partner. The women's concerns were focused on worry about fetal injury, miscarriage and waiting for the result. The test did not have a major psychological impact on the women in general, but a substantial minority reacted with anxiety and distress.

Conclusions: Knowledge of factors important to women and their concerns is essential for professionals working with genetic counselling and performance of invasive procedures.