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Maternal haemodynamics assessment in preterm delivery: two different haemodymanic profiles

Farsetti D, LoPresti D, Pisani I, Tiralongo GM, Gagliardi G, Vasapollo B, Novelli GP, Valensise H

Presented: Second International Congress on Maternal Haemodynamics

Published: Second International Congress on Maternal Haemodynamics, 2016 Workbook

Introduction: The purpose of our study was to evaluate the maternal haemodynamic profile in women with diagnosis of threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease.

Targets: 68 patients with diagnosis of TPD were enrolled and assessed through non-invasive method (USCOM) to determine haemodynamic parameters. Cervix length assessment, vaginal and rectal swabs, blood inflammatory indexes, foetal vessel Doppler velocimetry, gestational age at the delivery and neonatal outcomes were considered.

Results: The population was divided into two groups according to total vascular resistance (TVR) in Group A<=lOOO dynes.sec.cm-5, and Group B>lOOO dynes.sec.cm-5. Creactive protein was higher in Group B vs. Group A, suggesting a systemic inflammation status. Group B delivered earlier (32 weeks+4 days vs 38 weeks+2 days, p <0.01), and neonatal outcome was worse vs. Group A. A significant lower cardiac output, cardiac index, cardiac power, inotropy index, and higher PE/KE in Group B vs. Group A.

Conclusions: Women with TPD diagnosis showing TVR values>lOOO dynes.sec.cm-5 and elevated CRP levels present high risk of preterm delivery. Impaired maternal cardiovascular adaptation during pregnancy in these patients might suggest a possible higher risk for future cardiovascular disease.