EP02.10: Evaluation of maternal hemodynamic and obstetric complications in pregnancy after assisted reproductive technology

Aim of our study was to identify maternal hemodynamic parameters for the prediction of maternal and obstetric complications in pregnancy after assisted reproductive technology (ART). We enrolled 28 pregnancy after ART and 75 spontaneous low-risk pregnancy between 27 and 28 weeks of gestation. All patients were subjected to a maternal hemodynamic evaluation using USCOM (UltraSonic Cardiac Output Monitor) method. As regards the starting hemodynamic condition, cardiovascular parameters obtained by USCOM showed significant differences between the two study groups. In particular, we found in the ART group higher total vascular resistance (1354,4 ±221,9 vs 899,3±142,1 p < 0,001) and pe/ke ratio (42,4 ±18,4 vs 20,2±8,8 p < 0,0001) values and lower stroke volume (65,3 ±10,7 vs 93,2 ±17,8 p < 0,0001) and cardiac output (5,66 ±0,9 vs 7,9±1,4 p < 0,0001) values, compared to spontaneous pregnancies. In the ART group there were an increased incidence of fetal and maternal compliations such as gestational diabetes, pregnancy induced hypertensive disorders, fetal growth restriction and preterm delivery. The ROC curves identified the following cut off for pregnancy complications: TVR> 1168 dyne-cm-sec-5, CO ≤ 6.67 L/min, SV ≤ 77.3 ml, INO ≤ 1.6 watt/m2 and PKR> 26.42. The univariate logistic regression analysis showed that all the parameters identified by means of the ROC curves are predictive of worse pregnancy ouctome. Multivariate analysis showed that the independent predictors are the TVR and the CO. Pregnancies after assisted reproductive technology are associated with a worse pregnancy outcome. This risk seems to be linked to a maternal cardiovascular maladaptation, identifiable by non-invasive methods.