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.