Stress and anxiety associated with prenatal diagnosis

Ingrid Kowalcek1

  • 1FA für Gynäkologie und Geburtshilfe, Endokrinologie und Reproduktionsmedizin, Spezielle Geburtshilfe und Perinatalmedizin, Brahmsstrasse 10, 23556 Lübeck, Germany. kowalcek@t-online.de

Prior to any specific prenatal diagnostic procedure, the pregnant woman should be counselled about the indications for the procedure and how the diagnosis would inform care. In addition, the risks and limitations should be clearly spelt out. The availability of non-invasive prenatal diagnostic procedures such as sonography appears to have led to a higher rate of acceptance of such procedures, especially in younger patients. The expectations of pregnant women and their partners concerning prenatal diagnosis focus on reducing uncertainty in regard to the normality of the pregnancy. However, any prenatal diagnostic procedure can cause emotional stress in the pregnant woman. There are two different types of stress in this situation. There may be anxiety about the invasive nature of the procedure and the attendant risk of the loss of a wanted pregnancy. There may also be anxiety over the outcome of the investigation. Any unexpected finding, especially an abnormal one, often has an adverse impact on the pregnant woman and her partner. Imaging of the unborn child on sonography, and revealing fetal movements and heartbeat, are increasingly a common and key experience in a pregnancy. With the advent of this now commonly shared experience, the male partner also gives up his roll as a passive onlooker and becomes more actively involved in the pregnancy. Couples require multidisciplinary care if an abnormal fetus is found.

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