The effect of supine positioning on maternal hemodynamics during late pregnancy

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Aimee HumphriesPeter Stone

Abstract

Introduction: Recent studies have demonstrated an association between maternal supine sleep position and an increased risk of late stillbirth. During late pregnancy, the gravid uterus compresses the inferior vena cava (IVC) when a woman lies in the supine position. The azygos system of veins is the dominant pathway of collateral venous return back to the heart in the event of acute obstruction of the IVC. It is suggested that this pathway provides adequate collateral venous circulation in the event of IVC compression in the supine position during late pregnancy. Objective: Investigate the effect of supine positioning on maternal hemodynamics during late pregnancy and the role of collateral venous circulation. Methods: Ethics approval was obtained and 12 women with singleton pregnancies between 35- and 38-week gestation underwent magnetic resonance imaging in the supine and left lateral decubitus positions using a Skyra 3T system (Siemens). Phase-contrast images were evaluated to measure cardiac output, blood flow through the azygos vein, and blood flow through the abdominal aorta (AA) and IVC at two levels: at the level of aortic bifurcation and immediately above the renal veins. Results: The supine position was associated with...Continue Reading

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