Effect of Video -Based vs Standard ınformation on Maternal Anxiety and Procedure Decision in Pregnant Woman Offered Amniocentesis or Cvs

Invasive prenatal diagnostic procedures, such as Amniocentesis and Chorionic Villus Sampling (CVS), are associated with significant maternal anxiety driven by fear of procedural complications, pregnancy loss, and uncertainty regarding fetal health. Standard verbal informed consent processes may sometimes fail to fully address patient concerns due to time constraints or complex medical terminology.

This prospective study aims to investigate whether standardized, multilingual video-based educational material enhances patient comprehension, reduces state anxiety, and influences procedure acceptance rates among women offered invasive prenatal testing.

The study includes four distinct arms/groups based on the intervention type (video-assisted vs. standard consent) and the recommended procedure (amniocentesis vs. CVS). Baseline maternal characteristics, state-trait anxiety levels (STAI-T and STAI-S), and Intolerance of Uncertainty Scale (IUS-27) scores are evaluated at baseline (T0). Post-counseling anxiety levels (STAI-S) and the final decision to undergo or decline the recommended procedure (T1) are subsequently recorded and analyzed across groups.

• Multilingual Video-Based Patient Education (Behavioral): A standardized, multi-language educational video explaining the procedure, risks, benefits, and alternatives of invasive prenatal diagnostic tests.
• Standard Verbal Informed Consent (Behavioral): Routine clinical practice involving verbal discussion and standard printed informed consent documents.

Primary outcomes

• Change in Maternal State Anxiety Level [Immediately before and after counseling on the same day (baseline and post-intervention)]: Assessed using the State-Trait Anxiety Inventory-State (STAI-S) subscale (scores range from 20 to 80, with higher scores indicating higher state anxiety). Measured before and immediately after the educational intervention or standard counseling.
• Procedure Acceptance Rate [Immediately following the counseling session (Day 1)]: Percentage of pregnant women who decide to undergo or decline the offered invasive prenatal diagnostic procedure (amniocentesis or CVS) following the counseling session.

Secondary outcomes

• Baseline Trait Anxiety Level [Baseline (Day 1, prior to counseling)]: Evaluated using the State-Trait Anxiety Inventory-Trait (STAI-T) subscale (scores range from 20 to 80, higher scores indicate greater dispositional anxiety) to assess its baseline influence on maternal decision-making and response to video education.
• Intolerance of Uncertainty Score [Baseline (Day 1, prior to counseling)]: Assessed using the Intolerance of Uncertainty Scale (IUS-27) to evaluate baseline individual tolerance to uncertain outcomes and its potential mediating effect on procedure decision and post-counseling state anxiety.
• Impact of Primary Language Video Counseling on Anxiety Reduction [Immediately after counseling on the same day (baseline to post-intervention)]: Comparison of post-counseling state anxiety score (STAI-S) changes across patient subgroups receiving video-based education in their primary language (including Turkish, English, and Arabic) versus standard consent procedures.
• Influence of Obstetric History on Anxiety and Decision-Making [Baseline (Day 1, prior to counseling)]: Evaluation of the association between baseline state anxiety (STAI-S) and procedure acceptance rates with maternal demographic and obstetric factors, including gestational age, gravidity, parity, prior history of invasive diagnostic procedures, and specific indication for prenatal testing.

Sex: Female, ages: 18 Years to 45 Years, accepts healthy volunteers

Inclusion Criteria

* Presenting to the Perinatology Unit,
* Aged between 18 and 45 years,
* Having a singleton and live pregnancy,
* Recommended for invasive prenatal diagnostic testing due to medical indications,
* Proficient in reading, writing, and understanding the Turkish language,
* Willing to participate in the study (consenting to informed consent).

Exclusion Criteria:

* Having a history of psychiatric disorders or depression,
* Currently using psychiatric/psychotropic medication,
* Having a history of invasive procedures in previous pregnancies,
* Having a multiple pregnancy,
* Having visual, auditory, or cognitive impairments,
* Leaving more than 3 questions unanswered in the data collection tools (scales and forms) or withdrawing/dropping out of the study before completion.

• beste taş, md, Principal investigator, Ankara Bilkent City Hospital, Department of Obstetrics and Gynecology
• elif gül yapar eyi, md professor, Study director, Ankara City Hospital Bilkent