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Aortocaval Compression Syndrome develops when the pregnant uterus compresses the vena cava, a major vein that transports blood from the lower half of the body to the heart. This compression can lower blood flow to the heart and blood pressure, causing dizziness, lightheadedness, and fainting in pregnant women. The symptom is most common during the third trimester of pregnancy and is usually alleviated by shifting positions or lying on one’s left side.

Aortocaval Compression Syndrome :‎ [MEDNOTES+MINDMAP]

  • Definition
    • Aortocaval compression syndrome is a condition in which the inferior vena cava (IVC) is compressed between the aorta and the spine during late pregnancy or labor, leading to reduced blood flow to the uterus and the baby.
  • Epidemiology
    • Aortocaval compression syndrome is relatively rare, occurring in about 1 in 1000 pregnancies.
    • It is more common in women with large babies, multiple pregnancies, and certain medical conditions such as obesity, diabetes, and uterine fibroids.
  • Natural history
    • If left untreated, aortocaval compression syndrome can lead to fetal distress and stillbirth.
    • With timely diagnosis and treatment, the prognosis is generally good, with most women and babies making a full recovery.
  • Stages
    • Aortocaval compression syndrome can be classified into three stages:
      • Stage 1: Mild compression, with no symptoms or fetal distress.
      • Stage 2: Moderate compression, with symptoms such as reduced fetal movement and fetal distress.
      • Stage 3: Severe compression, with fetal distress and possibly stillbirth.
  • Risk Factors

    • Pregnancy
    • Obesity
    • Abdominal surgery
    • Enlarged uterus or ovaries
    • Prolonged standing or sitting
  • Etiology/Causes

    • Compression of the inferior vena cava and aorta by the uterus or other abdominal organs
  • Signs

    • Decreased blood flow to the lower extremities
    • Decreased urine output
    • Abdominal pain or discomfort
  • Symptoms

    • Shortness of breath
    • Lightheadedness or fainting
    • Swelling in the legs or ankles
  • Pathology/Pathogenesis

    • Decreased blood flow to the lower extremities results in reduced oxygen and nutrients to the tissues, leading to tissue damage and impaired function.
    • The compression of the aorta can also cause a decrease in blood pressure, leading to dizziness and fainting.
  • Diagnosis

    • Physical exam
    • Ultrasound
    • Doppler flow study
    • CT scan
    • MRI
  • Tests Required

    • Blood tests
    • Urine tests
  • Associated with

    • Pregnancy
    • Multiple fetuses
    • Obesity
    • Previous uterine surgery
    • Previous cesarean delivery
  • Similar diseases/syndromes

    • May-Thurner Syndrome
    • Nutcracker Syndrome
  • Treatment

    • Conservative treatment
      • Bed rest
      • Hydration
      • Blood transfusion
    • Surgical treatment
      • Ligation of ovarian veins
      • Inferior vena cava filter placement
      • Aortic and iliac artery stenting

Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER working in govt.health department
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