Effects of antepartum electronic fetal monitoring on maternal emotional state.

Background: To evaluate the emotional state of pregnant women undergoing computerised cardiotocography (cCTG).

Methods: A questionnaire including questions about socio-demographic background, personal obstetric history and physician-patient relationship was given to 204 pregnant women about to undergo cCTG. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess patients' mood state before CTG, while the Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels before and after this examination.

Results: Mean STAI T-anxiety score did not differ before and after CTG (p=0.38), but higher levels of basal anxiety were found in women who had undergone only occasional prenatal controls (p=0.04), as well as smokers (p=0.01), and women preferring a vaginal delivery (p=0.01). The mean STAI S-anxiety score of 43.6+/-4.03 before the cardiotographic examination, increased to 45.2+/-5.4 after this test with a statistically significant difference (p=0.0001). This increase was found to be correlated with the presence of obstetric complications during the current pregnancy (p=0.036) and a lower number of fetal active movements (p=0.029). Based on the EPDS, 22 patients (14.1%) were found to be depressed, but this condition was not correlated with significant increases in anxiety levels.

Conclusions: Anxiety levels in pregnant women who undergo routine CTG are increased, and this emotional reaction seems to be influenced by the perception of fetal movement during the examination, and is more evident in pregnancies affected by obstetric complications.