Aortocaval compression syndrome is compression of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, . Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas. Lee, Allison, J., MD ; Landau, Ruth, MD. Anesthesia & Analgesia: December Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas. Lee, A.J. ; Landau, R. Obstetric Anesthesia Digest: June – Volume 38 – Issue 2 – p.

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[Aortocaval compression syndrome].

Among term parturients placed supine, none showed a decrease in systolic arterial pressure AP or symptoms of ACC. Introduction Aortocaval compression syndrome is also known as a supine hypotensive syndrome.

Predominantly, the syndrome is provoked by placing the parturient supine. Palmer; Tilting at Aortocaval Compression.

Since supine positioning is required for diverse diagnostic and therapeutic procedures in obstetrics, these involve increased risk of aortocaval compression. It is important to point out that the CO measured in the supine position for this group of patients was within the normal range; however, when they were tilted, IVC compression is relieved resulting in an increase in venous return and hence CO. With advances in imaging modalities, non-invasive techniques such as magnetic resonance imaging have been used to demonstrate complete IVC compression with engorgement of the epidural venous plexus in near-term parturients lying in the supine position.

In the first and second trimesters, both the diastolic blood pressure and the systolic blood pressure decrease by 15 to 20 mmHg. Aortocaval compression syndrome is compression of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, i. Without knowledge of this pathophysiologic state, the syndrome will likely go unrecognized.


The uterus is located intra-abdominally at the same L4 — L5 vertebral level. Variations between femoral and brachial artery pressure with changes from hypertension to hypotension. Non-invasive arterial pressure AP measured in the upper and lower limbs was analysed to detect aortic compression.

When trauma is not involved, simply placing the patient in the left lateral position may be done. The impedance of blood flow back from the lower extremities to the maternal heart and central circulation occurs from compression of syndeome uterus on the clmpression vena cava, and also the aorta.

Accepted for publication September 19, Supine hypotensive syndrome is characterized by compressinotachycardiasweatingnauseahypotension and dizziness and occurs when a pregnant woman lies on her back and resolves when she is turned on her side. Even if I put the question to the junior residents in our training program who have completed their obstetric anesthesia rotation, I am sure that almost all there are always outliers! Infobox medical condition new All stub articles.

Aortocaval Compression Syndrome – StatPearls – NCBI Bookshelf

We have emailed you at with instructions on how to set up a new password. All patients were delivered by Caesarean section uneventfully. A correction has been published: You can help Wikipedia by expanding it. This method measures beat-to-beat flow velocity across the aortic valve using continuous-wave Doppler ultrasound.

Gestational pemphigoid Impetigo herpetiformis Intrahepatic cholestasis of pregnancy Linea nigra Prurigo gestationis Pruritic folliculitis of pregnancy Pruritic urticarial papules and plaques of pregnancy PUPPP Striae gravidarum.

Combined Doppler compressoon echocardiographic measurement of cardiac output: Int J Obstet Anesth. Recovery compresion Nulliparous Birth: Results are presented as mean and sd or median and range where appropriate.


Turn recording back on. Following this comlression, the aorta was implicated in the supine hypotensive syndrome, making the term aortocaval compression syndrome synonymous with the supine hypotensive syndrome. StatPearls Publishing ; Jan.

Its detection is difficult because in most patients, sympathetic compensation results in no signs or symptoms. A new password is required for A nesthesiology.

All of these symptoms are attributable to the impedance of blood flow back into maternal circulation aorrtocaval the lower extremities, which have increased venous pressures progressively throughout pregnancy. According to the Advanced Trauma Life Support Guidelines, tilting the backboard 15 to 30 degrees to the left right side upwards is an additional option.

A 16 G cannula was inserted into a forearm vein under local anaesthesia.

Is surgery even possible with a degree tilt? Noninvasive Doppler ultrasonography for assessing cardiac function: Patients with cardiovascular or cerebrovascular disease, pre-existing or pregnancy-induced hypertension, preeclampsia, or known fetal abnormality were excluded. This cardiovascular system article is a stub. In these patients, the mean CO was The contingency plan was not implemented for any patient as there were no episodes of hypotension or fetal HR abnormalities.

Similarly, Kinsella and colleagues 15 reported that aortic compression was not detected in 20 non-labouring parturients at term pregnancy. Particular attention should always synerome paid comrpession the vital signs, with knowledge as to normal changes in pregnancy as related to trimester.