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Condition affecting pregnant women

Aortocaval compression syndrome, also known as supine hypotensive syndrome, is a condition that can occur in pregnant women when the gravid uterus compresses the inferior vena cava and aorta while the woman is in a supine position. This compression can lead to decreased venous return to the heart, reduced cardiac output, and subsequent hypotension.

Pathophysiology

During pregnancy, the enlarging uterus can exert pressure on the inferior vena cava, which is the large vein that carries deoxygenated blood from the lower body back to the heart. When a pregnant woman lies on her back, the weight of the uterus can compress the inferior vena cava against the spine, reducing venous return. This can lead to a decrease in cardiac output and a drop in blood pressure, resulting in symptoms of hypotension.

The aorta, the main artery carrying oxygenated blood from the heart to the rest of the body, can also be compressed, although it is less susceptible to compression due to its thicker walls and higher pressure. However, aortic compression can still contribute to decreased perfusion of the lower body and placenta.

Symptoms

Symptoms of aortocaval compression syndrome can include:

• Dizziness or lightheadedness
• Nausea
• Sweating
• Pallor
• Tachycardia
• Fainting

These symptoms typically occur when the woman is lying flat on her back and are relieved by changing position, such as lying on the left side.

Diagnosis

Diagnosis of aortocaval compression syndrome is primarily clinical, based on the presence of symptoms when the patient is in a supine position and their resolution upon repositioning. It is important to differentiate this condition from other causes of hypotension in pregnancy.

Management

The primary management strategy for aortocaval compression syndrome is prevention and alleviation of symptoms by avoiding the supine position, especially in the later stages of pregnancy. Pregnant women are advised to lie on their left side, which helps to relieve pressure on the inferior vena cava and improve venous return.

In cases where the supine position is unavoidable, such as during certain medical procedures, tilting the patient to the left or using a wedge under the right hip can help mitigate the effects of compression.

Prognosis

With appropriate management, the prognosis for aortocaval compression syndrome is excellent. Avoiding the supine position typically resolves symptoms and prevents complications.

Related pages

• Pregnancy
• Hypotension
• Inferior vena cava
• Cardiac output

Gallery

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  Illustration of aortocaval compression syndrome

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