Ferber A, Onyeije C I, Zelop C M, O'Reilly-Green C, Divon M Y
Department of Obstetrics and Gynecology, Lenox-Hill Hospital, New York 10021, USA.
Ultrasound Obstet Gynecol. 2002 Jan;19(1):13-7. doi: 10.1046/j.0960-7692.2001.00606.x.
To investigate maternal perceptions of both pain and anxiety before and after genetic amniocentesis.
This prospective study of midtrimester, singleton pregnancies was conducted between March 2000 and July 2000. Study variables included patient demographics, medical and obstetric histories, indication for amniocentesis and a description of the source of information used by the patient regarding the procedure and technical degree of difficulty. Maternal pain and anxiety associated with performing amniocentesis were subjectively quantified with the use of the visual analog scale (VAS). Statistical analysis included Wilcoxon signed rank test, anova, and simple and stepwise regression analyses.
One hundred and eighty-three women participated in the study. Perception of pain before amniocentesis was significantly higher compared to that expressed immediately after the procedure, with a mean VAS score of 3.7 +/- 2.5 vs. 2.1 +/- 2.0 (P < 0.0001). Similarly, perception of anxiety was significantly greater prior to the procedure, with a mean VAS score of 4.6 +/- 2.8 vs. 2.8 +/- 2.4 after the amniocentesis (P < 0.0001). Perceptions of pain and anxiety were significantly and positively correlated to each other both before and after the procedure (P < 0.0001). History of a prior amniocentesis was the only variable associated with reducing expected pain and anxiety (negative correlation, P < 0.001), whereas the technical degree of difficulty was the only significant variable impacting on the actual pain and anxiety (positive correlation, P < 0.005).
Preamniocentesis counseling should emphasize the fact that, for most women, the actual pain and anxiety experienced during the procedure are significantly lower than expected. In fact, on a scale of 0-10, the mean level of pain was only 2.1, with a slightly higher mean level of anxiety.
调查孕妇在基因羊膜穿刺术前后对疼痛和焦虑的感知。
这项对孕中期单胎妊娠的前瞻性研究于2000年3月至2000年7月进行。研究变量包括患者人口统计学资料、医疗和产科病史、羊膜穿刺术的指征以及患者用于了解该操作及其技术难度的信息来源描述。使用视觉模拟量表（VAS）对与进行羊膜穿刺术相关的孕妇疼痛和焦虑进行主观量化。统计分析包括Wilcoxon符号秩检验、方差分析以及简单和逐步回归分析。
183名女性参与了该研究。羊膜穿刺术前的疼痛感知明显高于术后立即表达的疼痛感知，平均VAS评分为3.7±2.5对比2.1±2.0（P<0.0001）。同样，术前焦虑感知明显更大，羊膜穿刺术前平均VAS评分为4.6±2.8对比术后的2.8±2.4（P<0.0001）。术前和术后疼痛与焦虑的感知彼此之间均存在显著正相关（P<0.0001）。既往羊膜穿刺术史是与降低预期疼痛和焦虑相关的唯一变量（负相关，P<0.001），而技术难度是影响实际疼痛和焦虑的唯一显著变量（正相关，P<0.005）。
羊膜穿刺术前咨询应强调，对于大多数女性而言，该操作过程中实际经历的疼痛和焦虑明显低于预期。事实上，在0至10的量表上，平均疼痛水平仅为2.1，焦虑平均水平略高。
