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Supine hypotensive syndrome

S M Kinsella¹, G Lohmann

¹Department of Anaesthetics, Hammersmith Hospital, London, United Kingdom.

Obstetrics and Gynecology

|May 1, 1994

Summary

This summary is machine-generated.

Supine hypotensive syndrome in pregnant individuals causes severe symptoms and hypotension due to vena cava compression. Early detection involves monitoring supine intolerance and vital sign changes.

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Area of Science:

Obstetrics
Anesthesiology
Cardiovascular Physiology

Background:

Supine hypotensive syndrome (SHS) is a significant concern in late pregnancy.
It involves sudden hypotension when a pregnant individual lies flat on their back.

Purpose of the Study:

To review clinical presentations of SHS.
To explore mechanisms of SHS onset.
To identify methods for advance detection of SHS.

Main Methods:

Comprehensive literature search of obstetric, anesthesia, and medical journals from 1922 onwards.
Medline search from 1966 onwards with manual cross-referencing.
Inclusion of approximately 100 case reports and studies on supine blood pressure responses in late pregnancy.

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Main Results:

SHS is characterized by severe supine symptoms and hypotension, often compelling position changes.
Inferior vena cava compression by the uterus is the primary cause, influenced by uterine size and maternal/fetal positioning.
Advance recognition relies on a history of supine intolerance and supine-induced maternal heart rate increase and pulse pressure decrease.

Conclusions:

SHS can manifest from the fifth month of pregnancy, postpartum, or in pelvic tilt/sitting positions.
While vena cava compression is key, other factors modulate circulatory effects.
A spectrum of severity exists, making a definitive cutoff difficult; severe hypotension may occur without symptoms.