Here at OSR in Kailua, I am often asked by our pregnant patients if there are any positions which they are to avoid or how should they sleep while expecting. Lying on your back in the second and third trimesters of pregnancy can pose some issues for pregnant women. As the weight of the uterus, fetus, placenta, and amniotic fluid increases, the pressure can slow the circulation in your legs by compressing the inferior vena cava (the large vein carrying deoxygenated blood from the lower half of the body to the heart). This condition is known as supine hypotensive syndrome also called as aortocaval compression syndrome or maternal hypotension syndrome. When the inferior vena cava is compressed it reduces the amount of blood that returns to the heart and reduces cardiac output, this can result in a loss of 30% of the effective circulating blood volume. It can take up to three to seven minutes for significant hypotension to become manifest. Supine hypotensive syndrome can mimic symptoms of shock as the blood flow from the inferior vena cava is constricted, blood pressure drops and the uterine arteries contract and redirect blood to the major organs. Subsequent signs and symptoms include:
- Hypotension (low blood pressure).
- edema of the lower extremities.
- Signs of fetal hypoxia or distress.
- Decreased femoral pulse.
- Signs of shock such as cool, moist and clammy skin.
- Syncope or near syncope.
- Bradycardia in later stages.
Fortunately this syndrome can be easily prevented by proper positioning of pregnant female and avoiding extended periods of supine positioning. Medical and/or dental procedures which require supine positioning for extended periods of time should be avoided or discontinued as an evidenced based best practice of patient care. If the patient is unconscious and supine than the patient can be placed in left lateral recumbent position. If the patient is awake and symptoms of hypotension have resolved then the patient should be asked to sit up and lay on either side preferably on the left side until symptoms resolve. Here at Oahu Spine & Rehab we offer chiropractic care and massage to expectant mothers frequently! We are happy to help ease some of the aches and pains of pregnancy!
Hope this helps all our expecting mothers out there!