Table 1 Summary of the included studies
Study ID | Study Design | NCT number | Site | Recruitment duration | Total Participants | Intervention | Control |
|---|---|---|---|---|---|---|---|
Melcer 2021 [15] | Open Label RCT | NCT04491149 | Israel | September to October 2020 | 65 | VR (35) | Control (30) |
Mohammadifard 2021 [16] | Single-blind RCT | IRCT20200401046914N1 | Iran | June to September 2020 | 60 | H7_Acupressure (30) | Control (30) |
Rekawek 2019 [18] | Open Label RCT | NCT03140293 | USA | October 2016 to May 2017 | 120 | lidocaine_injection (63) | Ethyl_chloride (57) |
Pongrojpaw 2007 [19] | Double-blind RCT | - | Thailand | October 2006 to April 2007 | 120 | Lidocaine_prilocaine_cream (60) | Placebo (60) |
Tuaktaew 2018 [17] | Double-blind RCT | NCT03035045 | Thailand | August 2016 to June 2017 | 240 | Paracetamol (120) | Placebo (120) |
Schoubroeck 2000 [24] | Open Label RCT | - | Belgium | April to November 1998 | 220 | lidocaine_injection (114) | Control (106) |
Wax 2005 [25] | Single-blind RCT | - | USA | - | 62 | Subfreezing_temperature_needle (29) | Room_temperature_needle (33) |
Telapol 2018 [26] | Open Label RCT | - | Thailand | May to November 2016 | 148 | Ethyl_chloride (74) | Control (74) |
Benchahong 2021 [27] | Single-blind RCT | TCTR20191115002 | Thailand | December 2019 to May 2020 | 480 | Ice_gel_pack_before_AC (120), Ice_gel_pack_after_AC (120), Ice_gel_pack_before_after_AC (120) | Control (120) |
Elimian 2013 [28] | Double-blind RCT | NCT 00583011 | USA | October 2007 to September 2009 | 76 | lidocaine_injection (36) | Control (40) |
Fischer 2000 [29] | Single-blind RCT | - | USA | April 1998 to July 1999 | 200 | Effleurage (103) | Control (97) |
Gordon 2007 [30] | Single-blind RCT | - | USA | January 1995 to March 2001 | 204 | lidocaine_injection (101) | Control (103) |
Hanprasertpong 2012 [31] | Single-blind RCT | - | Thailand | July 2009 to July 2010 | 372 | Ice_gel_pack_before_AC (184) | Control (188) |
Hanprasertpong 2015 [32] | Single-blind RCT | - | Thailand | July to September 2013 | 317 | Menthol (158) | Control (159) |
Hanprasertpong 2016 [20] | Single-blind RCT | - | Thailand | February to May 2013 | 332 | Music (161) | Control (171) |
Katsogiannou 2018 [33] | Single-blind RCT | - | France | March 2013 to February 2015 | 183 | Nitrous_oxide (93) | Control (90) |
Kuemanee 2021 [34] | Single-blind RCT | TCTR20191116001 | Thailand | December 2019 to March 2020 | 240 | Ice_gel_pack_before_AC (120) | Control (120) |
Homkrun 2019 [35] | Single-blind RCT | TCTR20170528001 | Thailand | June 2017 to January 2018 | 570 | Xylocaine (191) | Control (379) |
Kang 2020 [36] | Single-blind RCT | - | China | June 2012 to June 2014 | 100 | Psychological_intervention (48) | Control (52) |
Mojahed 2021 [37] | Open Label RCT | - | Iran | 2020 | 80 | Education (40) | Control (40) |
Study ID | Inclusion criteria | Exclusion criteria | Ascertainment of pain | Aim |
|---|---|---|---|---|
Melcer 2021 [15] | The trial was open to consecutive women who were going to get an obstetrically indicated mid-trimester AC | Women under the age of eighteen or with numerous pregnancies were not included in the sample. Women who needed pre-procedural anxiolytic or analgesic medication, had a history of motion sickness, epilepsy, or had a hearing or visual impairment were also eliminated | VAS | The study's objective is to compare the effectiveness of a VR intervention to a control group in terms of controlling acute pain and anxiety during amniocentesis |
Mohammadifard 2021 [16] | The following conditions had to be met in order to qualify: gestational age of 15 to 18 weeks, literacy, desired pregnancy, score of ≤ 53 on the Spielberger Anxiety Inventory, absence of any obstetrical issues or medical conditions, abstinence from drugs and alcohol, absence of abnormal hand findings, maternal BMI in the range of 18.5 to 30 and absence of any history of recurrent abortions (more than three consecutive abortions), amniocentesis, known mental | Due to their unwillingness to cooperate, active vaginal bleeding, hospitalization, failure to complete the intervention twice weekly or three times intermittently throughout the study, multiple failed attempts at amniocentesis, and unusual sensitivity to pressure point touch, the participants were excluded from the study | - | The purpose of this study was to find out how H7 Acupressure affected pregnant women's anxiety during amniocentesis procedures |
Rekawek 2019 [18] | The trial was open to all singleton pregnant women who underwent transabdominal CVS between 10 and 13 weeks and 6 days of gestation | Multiple pregnancies, known medication allergies, and hypersensitivity to local anesthetic were among the exclusion criteria | VAS | Therefore, the purpose of this study was to ascertain if topical ethyl chloride anesthetic spray administration compared to 1% lidocaine subdermal injection results in lower pain perception during transabdominal CVS |
Pongrojpaw 2007 [19] | All of the expectant women who took part in the current study gave their consent to have an AC at the Maternal–Fetal Medicine Unit and were referred for genetic counseling in the second trimester of pregnancy | Multiple pregnancies or severe congenital anomalies found by sonography were excluded, as were known or suspected allergies to lidocaine prilocaine, psychiatric disorders, multiple attempts to insert a needle, and switching the puncture site where the cream was given because of fetal activity | VAS | The current study set out to determine whether local lidocaine-prilocaine cream application did in fact lessen pain during mid-trimester genetic AC |
Tuaktaew 2018 [17] | For this study, the singleton pregnant patients undergoing their first genetic AC at Rajavithi Hospital's Department of Obstetrics and Gynecology were considered eligible | Psychiatric disorders, paracetamol allergies, AC in cases of suspected fetal anomalies identified by another prenatal diagnostic procedure, a patient's history of paracetamol use in the 24–48 h prior to the amniocentesis, and participants who declined to enroll in the study were the exclusion criteria | VAS | The study's goal is to determine whether paracetamol can reduce pain scores during AC |
Schoubroeck 2000 [24] | Pregnant women undergoing AC | Multiple pregnancies, a known or suspected lignocaine allergy, an AC performed right away following the sonographic discovery of a severe fetal abnormality, a psychiatric illness, and a lack of proficiency in Dutch are all factors | VAS and VRS | This study sought to determine whether local anesthesia reduced pain during AC |
Wax 2005 [25] | Participants in this institutionally approved study had to be females aged ≥ 18 who underwent an indicated second trimester genetic amniocentesis, be carrying a singleton, have a normal amniotic fluid volume, and not have had an amniocentesis or chorionic villus sampling (CVS) in the previous pregnancy | Women who had previously undergone AC or CVS in the current pregnancy | VAS | In order to lessen pain associated with second trimester genetic AC, we conducted a randomized single-blinded trial comparing needles that were frozen to those that were at room temperature |
Telapol 2018 [26] | Women who had never undergone AC and no fetal gross structural abnormalities detected by ultrasonographic examination were the inclusion criteria | Women who were known to be allergic to colds, ethyl chloride spray, had taken painkillers within the previous four hours, needed more than one puncture during the same procedure, could not follow the study's methodology, or had poor communication skills, were all excluded from the study | VAS | This study's goal was to evaluate the cryo-analgesic impact of ethyl chloride spray on pain management during AC in the second trimester |
Benchahong 2021 [27] | Pregnancy, being between the ages of 18 and 45, having between 15 and 20 weeks of gestation, being without any ultrasonographic signs of foetal anomalies, and choosing AC as the prenatal diagnosis procedure are the inclusion criteria | Multifetal pregnancy, ultrasound evidence of a severe congenital anomaly, altered puncture site following cold compression during AC, repeated attempts, history of cold urticaria, pregnancy with Raynaud's phenomenon, use of painkillers that impair pain and temperature perception, abdominal skin infection, pregnancy with psychosis, and patients' refusal are all exclusion criteria | VAS | Evaluating the impact of cold therapy on a patient's perceived pain levels before and after an AC surgery |
Elimian 2013 [28] | Ages between 18 and 45, consent for participation, singleton pregnancies, and gestational ages between 15 and 23 weeks were all inclusion criteria | We disqualified multiple-gestational women, people taking painkillers or other analgesics, people who declined to participate, and people who have a known lidocaine hypersensitivity. Additionally, we didn't include cases in which amnioinfusion or amnioreduction were advised | VAS and NRS | Assessing how local anaesthetic affects how much pain the mother feels during AC |
Fischer 2000 [29] | - | - | VAS | Determining whether leg rubbing with gentle pressure during genetic AC lessens pain and anxiety associated with the procedure |
Gordon 2007 [30] | - | - | VAS and NRS | The null hypothesis states that local anaesthetic does not reduce AC patient pain perception |
Hanprasertpong 2012 [31] | Women who had second-trimester genetic AC due to advanced maternal age who were between 15 and 21 weeks pregnant (according to the latest menstrual period or ultrasonographic-biometric measurement) | Multiple pregnancies, a history of AC during a prior or ongoing pregnancy, the presence of foetal structural malformation, more than one attempt at needle insertion, participants who were unable to read or understand the questionnaire, or participants who declined to participate in our study were all exclusion criteria | VAS | Determining whether cryoanalgesia reduces the level of pain experienced during genetic AC in the second trimester |
Hanprasertpong 2015 [32] | Expectant women scheduled for genetic AC between 15 and 20 weeks of gestation because of advanced maternal age | A foetal structural malformation, multiple pregnancies, AC experience during the current or a previous pregnancy, multiple needle insertion attempts, a history of smell or taste perception issues, a history of an upper respiratory infection or a diagnosis of allergic rhinitis within two weeks of the procedure, an inability to read or understand the questionnaire, and a refusal to participate in the study were all grounds for exclusion | VAS | Assessing the effectiveness of menthol-based aromatic treatment to reduce AC-related pain |
Hanprasertpong 2016 [20] | Women who had a second trimester genetic AC due to advanced maternal age and were between 15 and 21 weeks pregnant based on their previous period or an ultrasonographic biometric measurement | Multiple pregnancies, foetal structural malformations, history of AC in a prior or ongoing pregnancy, multiple attempts at needle insertion, a history of hearing impairment, and participants who were illiterate, incapable of understanding the questionnaires, or who refused to participate in the study were all disqualified | VAS | Determining whether listening to music during genetic AC in the second trimester reduced pain perception |
Katsogiannou 2018 [33] | Patients had to be pregnant adults (over 18), have gestational ages between 11 and 16 weeks, be receiving transabdominal CVS, have no contraindications to using N2O or local anaesthetic, and have no contraindications to transabdominal CVS | - | VAS | Our goal was to assess how well nitrous gas and local anaesthetic managed pain and anxiety during transabdominal CVS |
Kuemanee 2021 [34] | The present study included pregnant women who had genetic AC between 15 and 22 weeks of gestation | Multifetal pregnancy, severe congenital anomaly previously detected by ultrasonography, cases of multiple needle puncture attempts during the procedure, cases of changing the puncture site due to foetal behavior, maternal psychiatric disorder, those who were contraindicated to cold therapy, and cases of refusal to participate in the current study were excluded | VAS | Assessing the impact of cryotherapy on pain management during genetic AC in the second trimester |
Homkrun 2019 [35] | Singleton pregnancy and gestational ages of 16 to 20 weeks based on a trustworthy last menstrual cycle and sonographic biometry in the first half of pregnancy were the inclusion criteria | Pregnant women who (1) had a history of Xylocaine allergy, (2) had aberrant sensory function based on history, (3) couldn’t rate their pain using a visual analogue scale, and (4) couldn’t do an AC were excluded | VAS | Evaluating the impact of Xylocaine spray on the AC pain score |
Kang 2020 [36] | - | - | VAS | The purpose of this study is to investigate how psychological psychotherapy can reduce pregnancy-related anxiety and dread in pregnant women as well as the surgical success rate |
Mojahed 2021 [37] | Muslim and Iranian ethnicity, written informed consent to participate in the study, a minimal level of literacy, AC eligibility, gestational age of 15–20 weeks, a single pregnancy with a viable fetus, and a positive foetal screening test were the inclusion criteria | The study's initial exclusion criteria included pregnancy after infertility treatment and assisted reproductive techniques, history of AC, history of recurrent miscarriages, presence of major abnormalities in ultrasound, awareness of the specifics of amniocentesis, use of hookah, cigarettes, drugs, alcohol, psychotropic drugs, history of consulting a psychiatrist or psychologist for mood and mental disorders, taking medication, or hospitalization | - | The purpose of this study was to ascertain how schooling affected moms who were amniocentesis candidates' perceptions of stress |