Virtual Fetal Touch Through a Haptic Interface Decreases Maternal Anxiety and Salivary Cortisol

Abstract

Objective: To evaluate whether a virtual reality workstation (Fetouch system) offering three-dimensional (3D)fetal visual and kinesthetic interaction may affect maternal stress.

Methods: Maternal-fetal visual and kinesthetic interaction was obtained through a haptic interface based on 3D reconstruction of sequencial bi-dimensional ultrasound images of the fetus. Maternal stress was assessed before and after visual/kinesthetic interaction with the fetus: 1) by using the State Trait Anxiety Inventory-Form Y (STAI) test, and 2) by measuring salivary cortisol levels. Statistical analysis was performed by paired t test and analysis of variance for repeated measures.

Results: After the fetal visual and kinesthetic experiences, a significant reduction was observed in anxiety (low state anxiety group, P < .0034; high state anxiety group, P < .0108), as well as in salivary cortisol concentration (P < .0004).

Conclusion: Physical interaction with thefetus through a 3D model may reduce maternal stress.

Keywords

Pregnancy three-dimensional ultrasound haptic interface cortisol stress

Get full access to this article

View all access options for this article.

References

1. Shich C , Kravitz M , Wang HH . What do we know about maternalfetal attachment? Kaohsiung J Med Sci 2001;17:448-454.

2. Mikhail MS , Freda MC , Merkatz RB , Polizzotto R , Mazloom E , Merkatz IR . The effect of fetal movement counting on maternal attachments to fetus. Am J Obstet Gynecol 1991;165:988-991.

3. Rankin RN , Fenster A , Downey DB , Munk PL , Levin MF , Vellet AD . Three-dimensional sonographic reconstruction: Techniques and diagnostic applications. AJR Am J Roentgenol 1993;161:695-702.

4. Reading AE , Chang LC , Kerin JF . Attitudes and anxiety levels in women conceiving through in vitro fertilization and gamete intrafallopian transfer. Fertil Steril 1989;52:95-99.

5. Reading AE , Platt LD . Impact of fetal testing on maternal anxiety. J Reprod Med 1985;30:907-910.

6. Ruspini DC , Kolarov K , Khatib 0 . The haptic display of complex graphical environments. Comput Graph 1997;31:345-352.

7. Steiner H , Staudach A , Spitzer D , Schaffer H . Three dimensional ultrasound in obstetrics and gynecology: Technique, possibilities and limitations. Hum Reprod 1994;20:923-936.

8. Cotin S , Delingette H , Ayache N . Real-time elastic deformations of soft tissues for surgery simulation. IEEE Trans Visual Comput Graph 1999;5:62-73.

9. Hajnor DR , Pagulatos N , Edwards WS , Kim Y . Interactive 3D registration of ultrasound and magnetic resonance images based on a magnetic position sensor. IEEE Trans Inf Technol Biomed 1999;3:278-288.

10.

10. Lorensen WE , Cline HE . Marching cubes: A high resolution 3D surface construction algorithm. Comput Graph 1987;21:163-169.

11.

11. Goldenderg RL , Hickey CA , Cliver SP , Gotlieb S , Woolley TW , Hoffmann HJ . Abbreviated scale for the assessment of psychological status in pregnancy: Development and evaluation. Acta Obstet Gynecol Scand Suppl 1997;165:19-29.

12.

12. Van der Bij AK , de Weerd S , Cikot RJ , Steegers EA , Braspenning JC . Validation of the Dutch short form of the state scale of the Spielberg State-Trait Anxiety Inventory: Considerations for usage in screening outcomes. Community Genet 2003;6:84-87.

13.

13. Hundley V , Gurney E , Graham W , Rennie AM . Can anxiety in pregnant women be measured using the State-Trait Anxiety Inventory? Midwifery 1998;14:118-121.

14.

14. Rondo PH , Ferreira RF , Nogueira F , Ribeiro MC , Lobert H , Artes R . Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr 2003;57:266-272.

15.

15. Field T , Diego M , Hernandez-Reif , et al. Pregnancy anxiety and comorbid depression and anger: Effects on the fetus and neonate. Depress Anxiety 2003;17:140-151.

16.

16. Allolio B , Hoffmann J , Linton EA , Winkelmann W , Kusche M , Schulte HM . Diurnal salivary cortisol patterns during pregnancy and after dehvery: Relationship to plasma corticotrophin-releasing-hormone. Clin Endocrinol (Oxf) 1990;33:279-289.

17.

17. Petraglia F , Hatch MC , Lapinski R , et al. Lack of effect of psychological stress on maternal corticotrophin-releasing factor and catecholamine levels at 28 weeks' gestation. J Soc Gynecol Investig 2001;8:83-88.

18.

18. Castro M , Elias PC , Martinelli CE Jr , Antonini SR , Santiago L , Moreira AC . Salivary cortisol as a tool for physiological studies and diagnostic strategies. Braz J Med Biol Res 2000;33:1171-1175.

19.

19. Kirschbaum C , Hellhammer DH . Noise and stress-salivary cortisol as a non-invasive measure of allostatic load. Noise Health 1999;1:57-66.

20.

20. Weibel L . Methodological guidelines for the use of salivary cortisol as biological marker of stress. Presse Med 2003;32:845-851.