Maternal and fetal Doppler velocimetry in women diagnosed with fear of childbirth

Objectives

We hypothesised that women with fear of childbirth (FOC) may have increased vascular resistance in maternal and foetal vascular beds due to maternal psychological stress. For this purpose, we investigated pulsatility (PI) and resistance (RI) index values for uterine, umbilical and mid cerebral arteries in term pregnant women who were diagnosed with FOC and we compared these values than those of women without FOC.

Methods

Women between 20-40 years with full-term singleton pregnancies (>= 37 gestational weeks) were included. All patients were questioned with Turkish form of Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A. Maternal age, gestational week, parity, body mass index and total W-DEQ scores of patients were recorded. Women with W-DEQ scores >= 85 was defined as FOC. Forty women diagnosed with FOC (FOC group) and 45 women with W-DEQ scores < 85 (control group) underwent Doppler waveform analysis and the pulsatility (PI) and resistance (RI) index values for uterine, umbilical and mid cerebral arteries were recorded. Data were analysed using SPSS software 12.0 (SPSS Inc., Chicago, IL, USA) and expressed as mean ± standard deviation, P < 0.05 was considered significant. The normality of variables was tested using the Kolmogorov-Smirnov test. If the data was not normally distributed, Mann-Whitney U-test was used. Comparisons were done using the independent samples t-test when the data was normally distributed and the Fisher’s exact test was used to compare the percentage values.

Results

There were no differences between groups in terms of maternal age, parity, body mass index and gestational week values. Control group had lower W-DEQ scores compared with FOC group (P < 0.001). Doppler flow parameters in groups were presented in Table 2. Both groups had similar PI and RI values for umbilical and mid cerebral arteries (P > 0.05). However, PI and RI values for both right and left uterine arteries were higher in FOC group than control group (P < 0.05, for right uterine artery PI; P < 0.001, for left uterine artery RI and P < 0.01, for others) (Table 2).

Conclusions 

It may be suggested that the presence of FOC in term pregnant women seems to have a negative effect on uterine blood flow parameters. When diagnosed with FOC, the women should be referred to a specialist for psycho-education and psychosomatic support in order to decrease her fear and to minimize the negative impact of fear on the foetus.

Keywords

Fear of childbirth, fetüs, Doppler

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	Table 1 Data were expressed as mean ± SD. *P < 0.001; compared with the control group.
	Table 2 *P < 0.05; †P < 0.01, **P < 0.001; compared with control group.