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Master Thesis

Impact de l’analyse chromosomique par puce à ADN (ACPA) sur les représentations maternelles et l’état émotionnel des mères

Abstract : Abstract: Impact of array comparative genomic hybridization (CGH-array) on maternal representations and emotional status. New techniques of chromosomal analysis by CGH-array, performed after the discovery of anomalies at the foetal ultrasound, have complicated the challenges of prenatal diagnosis.
Objective: To Assess the impact of the chromosomal analysis by CGH-array focusing on the mother's emotional response and their representations of themselves and their future child.
Method: This is a cross-sectional study based on semi-structured interviews in the immediate postpartum period. We have compared 3 groups of women. One composed by 10 women presenting soft markers at the time of foetal echography who were then explored by CGH Array which delivered normal results. A second group of 10 women without any anomalies whatsoever. The third one including 18 women for whom it was found signs (soft markers) at the time of foetal echography during their pregnancy in 2007, before the introduction of the CGH-array and whose child at birth was healthy. Two variables were analyzed: the maternal representations throw IRMAG (Interview of maternal representations of attachment), the mother's emotional situation throw the analysis of anxiety (Covi scale and auto questioning of Spielberger) and the degree of depression (Raskin Depression Rating Scale).
Results: Comparatively with the witness group, patients of the CGH-array group had significantly higher scores of depression (Raskin scale 3,8 vs 2), less rich representations (IRMAG scale 2,5 vs 3,8), a less structured discussion (3 vs 4,1), less fantasies (2,1 vs 3,5) and a more important social dependence (3 vs 2). Their anxiety, as their ability to adapt to the situation, their intensity of investment and the differentiation of the child were not significantly different compared with the witness group. Compared to the 2007 group that has not benefited from the CGH-array, patients of the CGH-array group had similar scale of anxiety and depression levels. We didn't found any differences in the consistence of their talking, in the richness of their perceptions, in their social dependence, and in the raising of fantasies. The intensity of investment and differentiation (3.2 vs 2.4) of the child, however, were significantly higher in the CHG-array group than in the group who did not have this type of prenatal diagnosis.
Conclusion: Prenatal diagnosis with CHG-array comes with an increase in depressive traits and an alteration of maternal representations after the birth of a child finally healthy. This impact don’t differ from what was observed in similar diagnostic situations before the introduction of this method.
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  • HAL Id : dumas-01191897, version 1

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Margaux Decherf. Impact de l’analyse chromosomique par puce à ADN (ACPA) sur les représentations maternelles et l’état émotionnel des mères. Gynécologie et obstétrique. 2015. ⟨dumas-01191897⟩

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