The Effect of Virtual Reality Glasses on Fetal Movement
Condition: Virtual Reality
Study type: Interventional

Summary: 
      When the literature is examined, it is seen that virtual reality glasses are used during
      medical procedures, have an anxiety-lowering effect and have a reducing effect on the
      perception of fatigue (20, 7, 10, 11). On the other hand, no study has been found in the
      literature on the application of virtual glasses to pregnant women who underwent NST.
      However, in line with the results of the study on virtual glasses, it is thought that the
      application of virtual glasses will also have a positive effect on the Reactive (Negative)
      Non-Stress Test result by reducing the anxiety level of pregnant women and increasing fetal
      movement and fetal cup speed in pregnant women with NST.

      This study was planned to examine the effects of virtual reality glasses, one of the
      cognitive behavioral techniques, on fetal movement, fetal heart rate, maternal satisfaction
      and anxiety level.
    

Detailed description: 
      One of the parameters used in the evaluation of fetal health during pregnancy is the
      Non-Stress Test (NST). When a healthy fetus moves, the oxygen requirement increases, the
      fetus increases the cardiac output to meet this requirement, and this is reflected in the
      trace as acceleration. Increased fetal heart rate during fetal movements; Adequate
      oxygenation, healthy transmission between the fetal central nervous system and the heart, and
      the ability of the fetus to respond to stimuli indicate fetal well-being (4, 23). This
      physiological response of the fetus is evaluated with the Non-Stress Test. The best result of
      this test is between 30-32 days of pregnancy when the fetal central nervous system
      development is completed. It is applied starting from these weeks in order to evaluate fetal
      health in routine pregnancy follow-ups (4). The results of the Non-Stress test are evaluated
      under two headings: Reactive (negative) and non-reactive (positive) NST. 1) Reactive
      (Negative) Non-Stress Test: At least two fetal movements within 20 minutes, fetal heart rate
      (FKA) being more than 15 beats (increase) than basal fetal heart rate in parallel with the
      movements, and accelerations lasting more than 15 seconds (fetal heart rate increases). 2)
      Non-reactive (Positive) Non-Stress Test: It is the situation in which there are accelerations
      (fetal heart rate increases) that are less than 15 beats and last less than 15 seconds
      despite the absence of fetal movements or fetal movements (4). The expected result in a
      healthy fetus is the Reactive (Negative) Non-Stress Test result. In the study of one it was
      found that 95% of the pregnant women were followed up for NST in the antepartum period (18).

      The results of the Non-Stress test; Variables in the external environment (such as maternal
      abdominal palpation, voice, and fetal sleep) may affect the procedure (4). In the literature,
      it has been reported that some practices such as listening to music while applying the
      Non-Stress test, relaxation exercises and relaxation training increase the Reactive
      (Negative) Non-Stress Test result expected in fetal well-being, increase the average number
      of accelerations, and cause a significant decrease in the level of anxiety in pregnant women
      (1,3,6,12,13,19,21-25). It was reported that the mean number of accelerations was 8.9±3.9 in
      pregnant women who were listened to music during NST application, and 4.3±3.2 in pregnant
      women who were not listened to. Again, in this study, NST results were reported as reactive
      in 98.0% of pregnant women who were listened to music and 66% of those who were not listened
      to (6). Similarly, while Küçükkelepçe and Timur Taşhan's (2018) average number of
      accelerations while listening to music was 2.14 ± 1.12, the average number of accelerations
      in the control group was 1.29 ± 1.09. reported (19). In addition, in the study of In the
      study of one in which they examined the effect of relaxation training on the reactivity of
      NST, they reported that the rate of reactive NST in relaxation training was 53.2%, while the
      rate of non-reactive NST was 46.8% (1). Based on these studies in the literature, it is seen
      that these practices within the scope of midwifery care practices have an effect on the NST
      results. In recent years, virtual reality glasses application as one of these applications
      has taken its place in the literature. Although virtual reality glasses technology is a
      device, it has been widely used in the medical field in hospitals. When the literature is
      examined, it is seen that virtual reality glasses reduce the level of anxiety and reduce the
      perception of fatigue level (20, 7, 10, 11). In the literature, in a meta-analysis study on
      the effectiveness of VR glasses on pain and anxiety in pediatric patients undergoing medical
      procedures, it was reported to be effective in reducing anxiety (SMD = 1.32; 95% CI,
      0.21-2.44; P = .020) (29). In another meta-analysis, it is seen that virtual reality glasses
      are effective in reducing pre-operative anxiety (30) Again,one in the study of It has been
      reported that they have pre-anxiety anxiety and that virtual reaIn the study of onelity
      glasses can be a potential tool to provide low perception of fatigue levels (20).
    

Intervention name(s): Virtual Reality Glasses
Intervention type(s): Device
Intervention description(s): Virtual Reality Glasses
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Virtual Reality; Fetal Movement; Fetal Heart Rate; Anxiety