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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The uterus is located intra-abdominally at the same L4 — L5 vertebral level. Cardiac output COstroke volume, and systemic vascular resistance were derived using suprasternal Doppler. This maneuver is simple, requires no expertise, and is not harmful to the uterus or fetus.

Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas.

As a result of this compression, the blood flow returning from the extremities may be impeded drastically, resulting in maternal hypotension. Author Information Authors Diann M.

This pathophysiologic state occurs in a pregnant female, typically after 20 weeks gestation, when the patient is placed in the percent position.

Testing the reliability of a new ultrasonic cardiac output monitor, the USCOM, by using aortic flowprobes in anesthetized dogs. StatPearls Publishing; Jan.

Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas.

You will receive an email whenever this article is corrected, updated, or cited in the literature. Close mobile search navigation Article navigation. Combined Doppler and echocardiographic measurement of cardiac output: We have taken a different approach to analysing the data in our study compared zortocaval other studies.

I will have to be less dogmatic about the practice however.


This simple bedside method for detecting ACC allows the determination of an optimal table tilt for positioning term parturient during surgery. Despite these drawbacks, there is at least one important lesson we should take away from this study. However, at term, the uterus commands an impressive milliliters per minute, which is a ten-fold increase. Aortic compression by the uterus: This cardiovascular system article is a stub.

Maternal and fetal effects of the supine and pelvic tilt positions in late pregnancy. As with any hypotensive patient, multiple etiologies should be simultaneously sought after and treated expeditiously. Digestive system Acute fatty liver of pregnancy Gestational diabetes Hepatitis E Hyperemesis gravidarum Intrahepatic cholestasis of pregnancy.

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!

A Randomized Dose-finding Trial. We have emailed you at aortpcaval instructions on how to set up a new password.

Evaluation Evaluation of aortocaval compression syndrome is done clinically alone.

[Aortocaval compression syndrome].

Furthermore, none of the pregnant women were laboring, and none had received a regional anesthetic; it is unclear how these variables might have impacted the findings. Guidelines for the Management of a Pregnant Trauma Patient. Particular attention should always be paid to the vital signs, with knowledge as to normal changes in pregnancy as related to trimester. Imaging techniques have also been used to show the presence of ACC.

CO and haemodynamic parameters for each lateral tilt. Patients with cardiovascular or cerebrovascular disease, pre-existing or pregnancy-induced hypertension, preeclampsia, or known fetal abnormality were excluded. Pathology of pregnancychildbirth and the puerperium O— By continuing to use our website, you are agreeing to our privacy policy.


This subsequently limits blood flow out to the placenta, and may result in morbidity and mortality to the mother and fetus alike.

Effects of the pregnant uterus on the extradural venous plexus in the supine and lateral positions, as determined by magnetic resonance imaging. Review [Aortocaval compression syndrome]. Since a direct effect of IVC compression is a decrease aortovaval CO, 10 we hypothesized that serial measurements of CO at different degrees of operating table tilt would enable cpmpression to identify the presence of IVC compression.

However, profound hypotension may develop after sympathectomy during regional anaesthesia. Suprasternal Doppler estimation of cardiac output: Aortocaval compression is thought to be the cause of supine hypotensive syndrome.

Tilting at Aortocaval Compression | Anesthesiology | ASA Publications

You can manage this and all other alerts in My Account. Syndromes Pathology of pregnancy, childbirth and the puerperium Anesthesia Cardiovascular system stubs Circulatory disease stubs. A 16 G cannula was inserted into a forearm vein under local anaesthesia. Forgot Password Forgot your password? Aortocaval compression by the uterus in late human pregnancy II.

These include, but are not limited to, traumatic hepatic, splenic or renal bleeding, pelvic fractures, ruptured uterus, placental abruption, amniotic fluid embolus, pulmonary embolus, sepsis syndorme other.

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.