RESULTS
We observed adverse outcomes in 44 patients (11.39%). In the table 1 are summarized the maternal characteristics at the time of enrollment.
There were no differences at the time of the enrollment between women who will experience complications and patients who won’t in terms of gestational age, maternal age, BMI, percentage of smokers and Cerebro-Placental Ratio (CPR) centile. Nevertheless, the rate of multiparity is higher in women who delivered without complications (27.71% vs 6.67%, p <0.01).
Women who will complicate during the labor had significantly higher DBP (77.36±9.51 mmHg vs 74.14±9.21 mmHg, P = 0.03), higher SVR (1368.32±228.50 d.s.cm-5 vs 1260.34±271.94 d.s.cm-5, p = 0.01), higher SVRI (2544.42±518.23 d.s.cm-5.m2 vs 2378.23±530.54 d.s.cm-5.m2, p = 0.05) and lower CO (5.38±0.77 l/min vs 5.80±1.20 l/min, p = 0.02) compared to controls. No significant differences were observed between the two groups in terms of SBP, SV, CI, INO, FTc, PKR (Table 1).
The group of women with complicated delivery had lower rate of induction (8.89% vs 24%, p<0.01), increased percentage of urgent C-section (68.89% vs 12.57%, p<0.01) and operative delivery (20.00% vs 8.29%, p<0.01), lower rate of clear amniotic fluid (73.33% vs 90.57%) and lower values of Apgar 1-min (8.00±1.51 vs 8.69±0.69, p<0.01) and Apgar 5-min (9.44±0.73 vs 9.72±0.75, p<0.02), compared to controls.
There were no differences in terms of gestational age at the time of delivery and the rate of epidural analgesia (71.11% vs 66.57%).
Table 2 and 3 reports the univariate logistic regression analysis for each continuous and categorical variable, including hemodynamic categorical variable obtained after identification of the cut-off through the ROC-curve analysis.
We perform a multivariate logistic regression analysis with multiparity and significant hemodynamic variables and we adjusted the cardiovascular effects for the maternal height that showed a significant association with outcome. The ORs obtained from the multivariate logistic regression analysis are summarized in the table 4. Independent predictors for delivery complications were parity, SVR and FTc.