{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T11:29:26Z","timestamp":1782646166221,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T00:00:00Z","timestamp":1523318400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if hemodynamic assessment in \u2018low\u2010risk\u2019 pregnant women at term with an appropriate\u2010for\u2010gestational age (AGA) fetus can improve the identification of patients who will suffer maternal or fetal\/neonatal complications during labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of 77 women with low\u2010risk term pregnancy and AGA fetus, in the early stages of labor. Hemodynamic indices were obtained using the UltraSonic Cardiac Output Monitor (USCOM<jats:sup>\u00ae<\/jats:sup>) system. Patients were followed until the end of labor to identify fetal\/neonatal and maternal outcomes, and those which developed complications of labor were compared with those delivering without complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven (14.3%) patients had a complication during labor: in seven there was fetal distress and in four there were maternal complications (postpartum hemorrhage and\/or uterine atony). Patients who developed complications during labor had lower cardiac output (5.6\u2009\u00b1\u20091.0 <jats:italic>vs<\/jats:italic> 6.7\u2009\u00b1\u20091.3 L\/min, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) and cardiac index (3.1\u2009\u00b1\u20090.6 <jats:italic>vs<\/jats:italic> 3.5\u2009\u00b1\u20090.7 L\/min\/m<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u2009=\u20090.04), and higher total vascular resistance (1195.3\u2009\u00b1\u2009205.3 <jats:italic>vs<\/jats:italic> 1017.8\u2009\u00b1\u2009225.6 dynes \u00d7 s\/cm<jats:sup>5<\/jats:sup>, <jats:italic>P<\/jats:italic>\u2009=\u20090.017) early in labor, compared with those who did not develop complications. Receiver\u2013operating characteristics curve analysis to determine cut\u2010offs showed cardiac output \u2264\u20095.8 L\/min (sensitivity, 81.8%; specificity, 69.7%), cardiac index \u2264\u20092.9 L\/min\/m<jats:sup>2<\/jats:sup> (sensitivity, 63.6%; specificity, 76.9%) and total vascular resistance &gt;\u20091069 dynes \u00d7 s\/cm<jats:sup>5<\/jats:sup> (sensitivity, 81.8%; specificity, 63.6%) to best predict maternal or fetal\/neonatal complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study of maternal cardiovascular adaptation at the end of pregnancy could help to identify low\u2010risk patients who may develop complications during labor. In particular, low cardiac output and high total vascular resistance are apparently associated with higher risk of fetal distress or maternal complications. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.17447","type":"journal-article","created":{"date-parts":[[2017,2,25]],"date-time":"2017-02-25T08:26:40Z","timestamp":1488011200000},"page":"509-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Maternal hemodynamics early in labor: a possible link with obstetric risk?"],"prefix":"10.1002","volume":"51","author":[{"given":"H.","family":"Valensise","sequence":"first","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-459X","authenticated-orcid":false,"given":"G. M.","family":"Tiralongo","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-2153","authenticated-orcid":false,"given":"I.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Farsetti","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Lo Presti","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Basile","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6010-3234","authenticated-orcid":false,"given":"G. P.","family":"Novelli","sequence":"additional","affiliation":[{"name":"Department of Cardiology San Sebastiano Martire Hospital  Frascati Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4942-5742","authenticated-orcid":false,"given":"B.","family":"Vasapollo","sequence":"additional","affiliation":[{"name":"Department of Biomedicine \u2010 Obstetrics and Gynecology Policlinico Casilino Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4094"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.10.024"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13319"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14647"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02009657"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.016"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a136192"},{"key":"e_1_2_5_9_1","article-title":"Pulmonary artery catheter (PAC) accuracy and efficacy compared with flow probe and transcutaneous Doppler (USCOM): an ovine validation","volume":"621496","author":"Phillips RA","year":"2012","journal-title":"Crit Care Res Pract"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2009.00948.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu162"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02916.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/17538157.2010.492923"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.024"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17371"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.105858"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2015.02.001"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1987.tb02286.x"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003664"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00738-8"},{"key":"e_1_2_5_21_1","first-page":"H1060","article-title":"Serial study of factors influencing changes in cardiac output during human pregnancy","volume":"136","author":"Robson SC","year":"1989","journal-title":"Am J Physiol"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199412011-00001"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.17447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.17447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:21:13Z","timestamp":1695540073000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.17447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1002\/uog.17447"],"URL":"https:\/\/doi.org\/10.1002\/uog.17447","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"2016-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}