loading page

Shock Index Values During the Peripartum Period in Patients Under Neuraxial Labour Analgesia: a Multicentre Prospective Cohort Study
  • +10
  • Jose Rojas-suarez,
  • Jeniffer Gonzalez-Hernandez,
  • Jezid Miranda,
  • Angel Paternina,
  • Walter Osorio,
  • Francisco Salcedo,
  • Jose Santacruz-Arias,
  • Walter Anichiarico,
  • Natalia Muñoz,
  • Maria Niebles,
  • Brenda Rodriguez,
  • Jorge Coronado,
  • Mauricio Vasco
Jose Rojas-suarez
Intensive Care and Obstetric Research Group, Universidad de Cartagena

Corresponding Author:joseantonio.rojas.suarez@gricio.com

Author Profile
Jeniffer Gonzalez-Hernandez
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Jezid Miranda
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Angel Paternina
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Walter Osorio
Universidad Pontificia Bolivariana Clinica Universitaria Bolivariana
Author Profile
Francisco Salcedo
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Jose Santacruz-Arias
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Walter Anichiarico
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Natalia Muñoz
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Maria Niebles
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Brenda Rodriguez
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile
Jorge Coronado
Department of Internal Medicine, Universidad de Cartagena
Author Profile
Mauricio Vasco
Intensive Care and Obstetric Research Group, Universidad de Cartagena
Author Profile

Abstract

Objective: We aimed to assess the association between intrapartum neuraxial labour analgesia (NLA) and shock index values during the peripartum period. Design: A multicentre prospective cohort study. Setting: Two reference centres in Colombia. Population: Obstetric patients in labour with term gestations were divided according to whether they underwent NLA between 2017 and July 2018. Methods: We collected maternal blood pressure and heart rate within the first and second stages of labour and every 30 minutes up to two hours postpartum. We assessed the association between intrapartum NLA and shock index values in a multivariable longitudinal mixed-effect model, adjusting for covariates. Main outcome measures: Shock index changes over time during labour and postpartum periods. Results: We included 522 patients, 228 (43.7%) with NLA and 294 (56.3%) without NLA. Except in the first stage of labour [0.68 (IQR, 0.63-0.74) vs 0.73 (IQR, 0.64-0.82); p=0.07], the shock index values were significantly higher in patients with NLA during the second stage of labour and postpartum (all p values <0.001). In the longitudinal mixed-effect model analysis, shock index values were higher in the NLA group. After adjusting the multilevel model by age, nulliparity, and cervical dilation, the mean shock index without NLA across the measurements was 0.69, while in NLA was 0.76 (mean difference of 0.067). Conclusions: In patients receiving NLA, the shock index values during labour differ from those during the postpartum period. Thus, under these conditions, the shock index should be interpreted differently. Keywords: Shock Index; Neuraxial Labour Analgesia; Postpartum Haemorrhage.
06 Aug 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
10 Aug 2022Assigned to Editor
10 Aug 2022Submission Checks Completed
02 Oct 2022Reviewer(s) Assigned