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'''Aortocaval compression syndrome''' is compression of the [[abdominal aorta]] and [[inferior vena cava]] by the [[pregnant|gravid]] [[uterus]] when a pregnant woman lies on her back, i.e. in the [[supine position]]. It is a frequent cause of low maternal [[blood pressure]] ([[hypotension]]), which can result in loss of [[consciousness]]<ref>{{cite journal |vauthors=Kiefer R, Ploppa A, Dieterich H | title = [Aortocaval compression syndrome] | journal = Der Anaesthesist | volume = 52 | issue = 11 | pages = 1073–83; quiz 1084 | year = 2003 | pmid = 14992095 | doi=10.1007/s00101-003-0596-6| s2cid = 8424182 }}</ref> and in extreme circumstances [[fetus|fetal]] demise.<ref>{{cite journal |vauthors=Banaś T, Godula Z, Herman R | title = [Aortocaval compression syndrome as an explanation of sudden intrauterine death of mature twins at term. Case report] | journal = Ginekol Pol | volume = 75 | issue = 8 | pages = 633–7 | year = 2004 | pmid = 15517787}}</ref><ref name=":0">{{Cite book|title=Nancy Caroline's Emergency Care in the Streets |edition=8th |last=American Academy of Orthopaedic Surgeons|publisher=Jones & Bartlett Publishers|year=2018|pages=2036}}</ref>
'''Aortocaval compression syndrome''' also known as '''Supine hypotensive syndrome''' is compression of the [[abdominal aorta]] and [[inferior vena cava]] by the [[pregnant|gravid]] [[uterus]] when a pregnant woman lies on her back, i.e. in the [[supine position]]. It is a frequent cause of low maternal [[blood pressure]] ([[hypotension]]), which can result in loss of [[consciousness]]<ref>{{cite journal |vauthors=Kiefer R, Ploppa A, Dieterich H | title = [Aortocaval compression syndrome] | journal = Der Anaesthesist | volume = 52 | issue = 11 | pages = 1073–83; quiz 1084 | year = 2003 | pmid = 14992095 | doi=10.1007/s00101-003-0596-6| s2cid = 8424182 }}</ref> and in extreme circumstances [[fetus|fetal]] demise.<ref>{{cite journal |vauthors=Banaś T, Godula Z, Herman R | title = [Aortocaval compression syndrome as an explanation of sudden intrauterine death of mature twins at term. Case report] | journal = Ginekol Pol | volume = 75 | issue = 8 | pages = 633–7 | year = 2004 | pmid = 15517787}}</ref><ref name=":0">{{Cite book|title=Nancy Caroline's Emergency Care in the Streets |edition=8th |last=American Academy of Orthopaedic Surgeons|publisher=Jones & Bartlett Publishers|year=2018|pages=2036}}</ref>


==Signs and symptoms==
Aortocaval compression is thought to be the cause of '''supine hypotensive syndrome'''. Supine hypotensive syndrome is characterized by [[pallor]], [[tachycardia]], [[sweating]], [[nausea]], [[hypotension]] and [[dizziness]] and occurs when a pregnant woman lies on her back and resolves when she is turned on her side.<ref>Sharma S. Shock and Pregnancy. eMedicine.com. URL: [http://www.emedicine.com/med/topic3285.htm http://www.emedicine.com/med/topic3285.htm]. Accessed on: March 11, 2007.</ref> Medical management of supine hypotensive syndrome can include turning the patient to the [[Recovery position|left recumbent position]] (so the uterus is not sitting on the [[Inferior vena cava|IVC]]) and administering [[IV fluids]].<ref name=":0" />
Aortocaval compression syndrome may cause syncope, restlessness, dizziness, headache, tinnitus, visual disturbances, numbness or paresthesia of the limbs, abdominal/chest discomfort or pain, nausea, and vomiting.<ref name="Comprehensive Review of Literature">{{cite journal | last=Zhao | first=Pei-Shan | title=Supine Hypotensive Syndrome: A Comprehensive Review of Literature | journal=Translational Perioperative and Pain Medicine | publisher=Transpopmed | date=September 1, 2014 |url=https://www.transpopmed.org/articles/tppm/tppm-2014-1-013.php | access-date=December 29, 2023 | page=}}</ref> Some patients may be asymptomatic.<ref name="Haemodynamic effects from aortocaval compression">{{cite journal | last=SW | first=Lee | last2=KS | first2=Khaw | last3=WD | first3=Ngan Kee | last4=TY | first4=Leung | last5=LA | first5=Critchley | title=Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women | journal=British journal of anaesthesia | publisher=Br J Anaesth | volume=109 | issue=6 | issn=1471-6771 | pmid=23059960 | doi=10.1093/bja/aes349 |url=https://pubmed.ncbi.nlm.nih.gov/23059960/ | access-date=December 29, 2023 | doi-access=free}}</ref>

The aorta and inferior vena cava are central vessels, the largest artery and vein. They supply blood to the heart, and the rest of the body. Thus, when there is compression due to the weight of the fetus, signs of [[Shock (circulatory)|shock]] (sweating, pallor, fast and weak pulse) may be experienced. Patients should be placed in a [[Left lateral decubitus position|left lateral recumbent position]] and emergency help summoned immediately.{{cn|date=February 2022}}


==See also==
==See also==
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==References==
==References==
{{reflist}}
{{reflist}}

==Further reading==
* {{cite journal | last=Chen | first=Shouming | last2=Wu | first2=Lan | last3=Jiang | first3=Xiaoqin | title=Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis | journal=BMC Anesthesiology | volume=19 | issue=1 | date=2019 | issn=1471-2253 | pmid=31272377 | pmc=6610927 | doi=10.1186/s12871-019-0791-x | doi-access=free | ref=none}}
* {{cite journal | last=AJ | first=Lee | last2=R | first2=Landau | title=Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas | journal=Anesthesia and analgesia | publisher=Anesth Analg | volume=125 | issue=6 | issn=1526-7598 | pmid=28759487 | doi=10.1213/ANE.0000000000002313 |url=https://pubmed.ncbi.nlm.nih.gov/28759487/ | access-date=December 29, 2023 | doi-access=free | ref=none}}

==External links==
* [https://medical-dictionary.thefreedictionary.com/supine+hypotensive+syndrome The Free Dictionary]
* [https://www.ncbi.nlm.nih.gov/books/NBK430759/ StatPearls]

{{Medical resources
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| ICD10 = {{ICD10|O26.5}}
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| ICD9 = {{ICD9|669.20}}
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| DiseasesDB = 29649
| SNOMED CT = 88887003
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{{Pathology of pregnancy, childbirth and the puerperium}}
{{Pathology of pregnancy, childbirth and the puerperium}}

Revision as of 21:50, 29 December 2023

Aortocaval compression syndrome
Other namesSupine hypotensive syndrome
A watercolor drawing of a pregnant woman lying flat on her back, causing the aorta and inferior vena cava to compress and reduce circulation.
SpecialtyObstetrics and gynaecology

Aortocaval compression syndrome also known as Supine hypotensive syndrome is compression of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, i.e. in the supine position. It is a frequent cause of low maternal blood pressure (hypotension), which can result in loss of consciousness[1] and in extreme circumstances fetal demise.[2][3]

Signs and symptoms

Aortocaval compression syndrome may cause syncope, restlessness, dizziness, headache, tinnitus, visual disturbances, numbness or paresthesia of the limbs, abdominal/chest discomfort or pain, nausea, and vomiting.[4] Some patients may be asymptomatic.[5]

See also

References

  1. ^ Kiefer R, Ploppa A, Dieterich H (2003). "[Aortocaval compression syndrome]". Der Anaesthesist. 52 (11): 1073–83, quiz 1084. doi:10.1007/s00101-003-0596-6. PMID 14992095. S2CID 8424182.
  2. ^ Banaś T, Godula Z, Herman R (2004). "[Aortocaval compression syndrome as an explanation of sudden intrauterine death of mature twins at term. Case report]". Ginekol Pol. 75 (8): 633–7. PMID 15517787.
  3. ^ American Academy of Orthopaedic Surgeons (2018). Nancy Caroline's Emergency Care in the Streets (8th ed.). Jones & Bartlett Publishers. p. 2036.
  4. ^ Zhao, Pei-Shan (September 1, 2014). "Supine Hypotensive Syndrome: A Comprehensive Review of Literature". Translational Perioperative and Pain Medicine. Transpopmed. Retrieved December 29, 2023.
  5. ^ SW, Lee; KS, Khaw; WD, Ngan Kee; TY, Leung; LA, Critchley. "Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women". British journal of anaesthesia. 109 (6). Br J Anaesth. doi:10.1093/bja/aes349. ISSN 1471-6771. PMID 23059960. Retrieved December 29, 2023.

Further reading

External links

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