Perinatal outcomes in pregnancies complicated by late-onset foetal growth restriction undergoing induction of labour

Objective. To observe adverse perinatal outcomes in a pop­ulation of pregnant women with late-onset FGR undergoing induction of labour.
Materials and Methods. We enrolled 66 pregnant women with late-onset FGR who underwent induction of labour with misoprostol. Before delivery we collected data about their last ultrasound scan to obtain the estimated foetal weight and ma­ternal haemodynamic evaluation with USCOM method.
Results. 24 patients underwent vaginal instrumental deliver­ies or urgent C-section for non-reassuring cardiotocography during labour. A higher proportion of multiparous women de­veloped adverse perinatal outcomes (96% vs 64%, p = 0.004), furthermore these patients showed an increased BMI (27 ± 3.3 vs 25 ± 3.1, p = 0.03) compared to patients with uncomplicated outcomes. The neonatal birth weight percentile appears to be significantly lower in the first group of patients (5 ± 5.3 vs 11 ± 13.2, p = 0.05) with 88% of cases below the 10th percentile (88% vs 62%, p = 0.03). Maternal haemodynamic evaluation showed increased values of mean arterial pressure (MAP) (88 ± 12.2 vs 82 ± 8.9, p = 0.01), systemic vascular resistances (SVR) (1072 ± 251.7 vs 942 ± 216.9, p = 0.03) and PKR (23 ± 7.9 vs 20 ± 6.6, p = 0.05) in patients who had worse outcomes. ROC curve anal­ysis was performed for BMI and haemodynamic parameters to test the predictive capacity of these variables in identifying patients at risk of develop adverse perinatal outcomes.
Conclusions. BMI (OR 4.25, p < 0.01) and SVRI (OR 16.88 p < 0.01) seem to be independent predictors of adverse perinatal out­come in pregnancies with FGR underwent induction of labour.