vena cava syndrome supine hypotensive syndrome can be prevented by

You or your baby are in a position that may press on the blood vessels. Anesthesia & Analgesia. If it continues to happen, call your doctor. Resultant symptoms usually mean that women in late pregnancy naturally avoid the supine position during sleep2. The condition gets its name because these pregnant women experience hypotension when lying on their backs, or in a “supine” position. The doctor says that Olivia’s baby and uterus are getting bigger, and the uterus can press down on one of Olivia’s main blood vessels, called the inferior vena cava. 2018 Dec;133:e164–73. Exertional Dyspnea & Supine Hypotensive Syndrome Symptom Checker: Possible causes include Hypertension. 2013;72(1):67-71. doi:10.5603/FM.2013.0011, Sanchez C, Chinn BT. in the supine position. In addition, due to the combination of lumbar and hard anesthesia, the muscles are relaxed, and the abdominal muscles cannot support the uterus. Diaphragm compression The maternal enlarged uterus will also compress the diaphragm, causing vagus nerve excitement, resulting in a slow heartbeat, dilated heart blood vessels, and a drop in blood pressure, which can lead to supine hypotension syndrome. The force of the blood through your arteries is your blood pressure. 1 The symptoms may be alleviated by changing the parturient patient to a left lateral position, or by shifting the weight of the uterus to the left. The superior vena cava is a short and wide vein on the right side of the chest that drains blood from the head, upper body and both arms, and delivers all of that blood to the right atrium of the heart. 2009;3. Often, treatment includes positional changes, avoidance of supine positioning, especially on the right side. 2015 Feb 1;125(2):347-55. doi:10.1097/AOG.0000000000000627. In addition, maternity births should choose regular hospitals. Obstetrics Gynecology. When the pregnant woman lies in the supine position, the weight of the fetus compresses the vena cava and descending aorta, decreasing the blood return to the right atrium. 203: Chronic Hypertension in Pregnancy. Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women. doi: 10.1097/AOG.0000000000003020, Humphries A, Mirjalili SA, Tarr GP, Thompson JM, Stone P. The effect of supine positioning on maternal hemodynamics during late pregnancy. Cardiac output can decrease by 30%–40% in patients with this syndrome. Hypertension Research. Obstet Gynecol. As long as you’re not having any complications and it’s safe, you can use. Supine hypotension syndrome is a type of low blood pressure that could be dangerous. Two numbers measure blood pressure. A 62-year-old man underwent removal of a suspected metastatic brain tumor. Treatment will vary depending on the cause of the vena cava compression or interruption. When lying flat on the back, approximately 10% of expecting women experience symptoms of supine hypotension within three to ten minutes. The symptoms include: As your pregnancy progresses, your uterus and baby grow and weigh more. Medically or surgically treating or removing the underlying cause. Krywko DM, King KC. By using Verywell Family, you accept our, Feeling Dizzy or Passing Out During Pregnancy, The Best Sleeping Positions During Pregnancy, Peripartum Cardiomyopathy: Symptoms, Diagnosis, and Treatment, Coping With Low or High Blood Pressure While Pregnant, What to Know About Vaginal Varicose Veins, All the Ways Your Body Changes During Pregnancy, 10 Tips for Better Sleep During Pregnancy, What You Should Know About Pregnancy (Prenatal) Massage, What to Expect During Pregnancy Ultrasounds, Aortocaval compression syndrome: time to revisit certain dogmas, ACOG Practice Bulletin No. To prevent supine hypotension, you can try not to lie flat on your back. It can lead to some squeezing of the vessels, but you may not feel the effects. Supine hypotension syndrome is more than a natural drop in blood pressure from pregnancy hormones or rest. 2015;126(6):e135-142. Chances are you’ll wake up and move if something isn’t right. Here are some concerning situations. Committee Opinion No. In other conditions, medical or surgical treatment to remove or relieve the offending structure will relieve symptoms. We report a patient who developed sustained hypotension during craniotomy; further, owing to a mediastinal mass, critical tracheal stenosis and brain edema were observed after craniotomy, despite the absence of preoperative symptomatic superior vena cava (SVC) syndrome. Committee Opinion No. Lying on your side can make your hips feel sore. Obesity. Each volunteer was asked to lie in 7 positions: lying horizontal on their left or right side (left lateral and right lateral), lying horizontal on their back (supine), lying on their back but tilted laterally to the left or right (left 12.5°, left 5°, right 5°, and right 12.5°). Hacker NF, Gambone JC, Hobel CJ. Kurien S, Kattimani VS, Sriram RR, Sriram SK, VK PR, Bhupathi A, Bodduru RR, Patil NN. 203: Chronic Hypertension in Pregnancy, The effect of supine positioning on maternal hemodynamics during late pregnancy, Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women, Prevention of supine hypotensive syndrome in pregnant women treated with transcranial magnetic stimulation, The collateral venous system in late pregnancy: A systematic review of the literature, Supine Hypotensive Syndrome: A Comprehensive Review of Literature, Management of pregnant patient in dentistry, Risk of inferior vena cava compression syndrome during fetal MRI in the supine position–a retrospective analysis, Committee Opinion No. (The inferior vena cava is the large vein which returns blood to the heart from the lower body; it is located at the back of the body near the spine.) It will also affect the vascular perfusion of the uterus, kidneys and placenta, resulting in intrauterine hypoxia, placental abruption, fetal heart rate slowing or fast or irregular, so that the fetus appears distressed in the uterus. Setty T, Bampoe S. Obesity in pregnancy. When you’re pregnant, and you lie flat on your back, the weight of the baby and your uterus press down on your spine and abdominal organs. The systolic pressure is the top number, and the diastolic pressure is the bottom number. The collateral venous system in late pregnancy: A systematic review of the literature. If you are on your back and you suddenly feel dizzy or strange, change your position. You may not even have any symptoms and not realize it's a bit low unless the doctor tells you at your prenatal visit. Regular hospitals have experience in responding to emergencies and scientific treatment procedures, which can prevent the hypotension syndrome of lying-in women in the supine position to the greatest extent, and provide greater protection for the life safety of women and fetuses. Whether birth or cesarean section, childbirth is an important “passing through” process in a woman’s life. Donna Murray, RN, BSN has a Bachelor of Science in Nursing from Rutgers University and is a current member of Sigma Theta Tau, the Nursing Honor Society. 766: Approaches to Limit Intervention During Labor and Birth. Over-the-counter drugs should also be used with caution in pregnant women, The pain everywhere in my body turned out to be heart disease, “Invisible killer” with heavy taste and health, Happy to start health under the epidemic 2021. syndrome is impairment of venous return to the heart and consequent reduction in cardiac output as a result of compression of the inferior vena cava by the tumour when the subject is supine2. A slight drop in blood pressure is typically not harmful to you or your baby. Respond to abnormalities in a timely manner. Not everyone does. Studies in awake pregnant women have demonstrated reduced ejection fraction and cardiac output in the supine position compared to the left lateral position that may reduce utero-placental blood flow to the fetus since the gravid uterus compresses the inferior vena cava. 2017 Feb 15;595(4):1017. doi:10.1113%2FJP273705. Compression of the Vena Cava and Descending AortaCompressing Vine Cave and Descending A-orca. Plus, when exercise is performed in the supine position, it is possible that an already reduced cardiac output would be preferentially redirected to the exercising muscles and … ‘supine hypotensive syndrome’ – was first highlighted almost 60 years ago1. It may go down when you're resting or up when you're active, excited, or stressed. 2011 Jan;34(1):55. doi:10.1038/hr.2010.172, Kucur SK, Acar C, Temizkan O, Ozagari A, Gozukara I, Akyol A. However, there is no need to panic if you wake up on your back because you rolled over while you were sleeping. Aortocaval compression syndrome. British Journal of Anaesthesia. The weight of the uterus applies pressure on the descending aorta and vena cava. Read our, Medically reviewed by Andrea Chisholm, MD, Medically reviewed by Brian Levine, MD, MS, FACOG, Verywell Family uses cookies to provide you with a great user experience. Bánhidy F, Ács N, Puhó EH, Czeizel AE. Management of pregnant patient in dentistry. Wome… Humphries A, Stone P, Mirjalili SA. Recent literature has reported an association between maternal supine sleep position and stillbirth during late pregnancy. Clinics in colon and rectal surgery. It may be due to:. To prevent Supine Hypertensive Syndrome (SHS), the American College of Obstetricians and Gynecologists (ACOG) advises women not to exercise on their backs (supine) after their first trimesters. Folia morphologica. The amount of blood in the heart will also drop rapidly, and the blood pressure will also decrease, causing hypotension syndrome in the supine position. Each pump sends the blood out with force. Besides supine hypotension and the natural change in circulation from pregnancy hormones, low blood pressure during pregnancy can have other causes. Journal of forensic sciences. pregnant women and are sometimes diagnosed as supine hypotensive syndrome. Treatment will vary depending on the cause of the vena cava compression or interruption. It is a frequent cause of low maternal blood pressure (hypotension), which can result in loss of consciousness and in extreme circumstances fetal demise. If your blood pressure goes down a little during pregnancy, you usually don't have to worry. Definition: Shocklike symptoms that occur when venous return to the heart is impaired by weight of gravid uterus causing partial occlusion of the vena cava… You can also use ice or heat to help relieve sore hips. It is a decrease of the systolic pressure (the top number) of at least 15 mm Hg to 30 mm Hg when lying on your back.. 2011 Mar;24(01):005-13. doi:10.1055/s-0031-1272818, Linicus Y, Kindermann I, Cremers B, Maack C, Schirmer S, Böhm M. Vena cava compression syndrome in patients with obesity presenting with edema and thrombosis. 2014 May 1;42(3):301-6. doi:10.1515/jpm-2013-0182, Committee on Obstetric Practice. Sleeping on your back in the second and third trimester is not recommended. Superior vena cava syndrome occurs when blood flow through the superior vena cava is obstructed either from within due to a blood clot or from external compression.. 2012 Oct 11;109(6):950-6. doi:10.1093/bja/aes349, Kim DR, Wang E. Prevention of supine hypotensive syndrome in pregnant women treated with transcranial magnetic stimulation. doi:10.1097/AOG.0000000000003074, Bishop DG. We report a case of a 41‐year‐old 39‐week‐pregnant woman found dead supine. 2019;133(1):e26-e50. Predicting spinal hypotension during Caesarean section. Back to basics: avoiding the supine position in pregnancy. Rarely, it may manifest even from the fifth month of pregnancy or postpartum, as well as in the pelvic tilt or sitting positions. How to prevent maternal supine hypotension syndrome Obstetrics and gynecology. This syndrome occurs in cesarean section, mainly related to the following factors: When the postpartum woman takes the supine position during cesarean section, the enlarged uterus in the third trimester will cause compression of the inferior vena cava and abdominal aorta, resulting in obstruction of pelvic and inferior vena cava return flow, and the blood reaching the heart is suddenly reduced. Maternal women have varying degrees of nervousness, depression, and other negative emotions due to the history of previous episodes or due to fetal position, twins, huge children, or abnormal birth canal. SIGNS AND SYMPTOMS. Maternal hemodynamic adaptations were found to be consistent across groups irrespective of whether the women had symptoms of supine hypotension. Try using pillows or a wedge to sleep tilted toward or on your left side and avoid exercising on your back. The pressure can squeeze two of the largest blood vessels in your body – the aorta and the inferior vena cava., Pressure on the aorta or vena cava can affect your circulation or the flow of blood in your body. Autopsy & case reports. In these instances of supine hypotension syndrome in pregnancy, simple repositioning can be life saving. Compression of your major blood vessels can affect your heart rate and circulation. The systolic pressure is the top number, and the diastolic pressure is the bottom number. Healthy blood pressure measures less than 120 millimeters of mercury (mm Hg) over 80 mm Hg.3 When you're pregnant, the hormone… When your blood pressure falls from lying on your back during pregnancy, it’s called supine hypotension syndrome. If the mother has a pelvic stenosis that is not proportional to the pelvis, horizontal position, twins, buttocks, huge children, and the mother has a supine hypotension In the history of syndrome, etc., after the maternal anesthesia, tilt the operating table about 30 degrees to the left and fix the maternal with restraint straps to prevent the maternal from falling into the bed. Hacker & Moore's essentials of obstetrics and gynecology. 2016 Aug;24(8):1648-52. doi:10.1002/oby.21506, De‐Giorgio F, Grassi VM, Vetrugno G, d’Aloja E, Pascali VL, Arena V. Supine hypotensive syndrome as the probable cause of both maternal and fetal death. These fetuses became hypotensive, they made gasping efforts and a … Committee Opinion No. Abstract: Supine hypotensive syndrome is characterized by severe supine hypotension in late pregnancy, whose clinical presentation ranges from minimal cardiovascular alterations to severe shock, resulting from inferior vena cava compression by gravid uterus. 3 described a significant decrease in blood pressure in 18 of 160 term parturients placed in a supine position; they ascribed the syndrome to occlusion of the inferior vena cava (IVC) by the gravid uterus. Secondly, how do you prevent supine hypotensive syndrome? When does the onset of labor begin? Your collateral circulation system (the extra pregnancy blood vessels) is not working well enough. Physical activity and exercise during pregnancy and the postpartum period. Journal of international oral health: JIOH. In-utero observations were made in 10 lambs during maternal hypotension. 2012 Nov;57(6):1646-9. doi:10.1111/j.1556-4029.2012.02165.x. Clinical Anatomy. Maternal supine hypotension syndrome is a syndrome in which the maternal dizziness, nausea, vomiting, rapid heartbeat, and varying degrees of blood pressure drop occur when the supine position is taken during cesarean section. Maternal supine position During pregnancy, lying flat on your back can worsen certain pregnancy symptoms such as heartburn and shortness of breath. 2019 Jun 6. The gravid uterus of late pregnancy normally causes aortocaval compression. Transl Perioper & Pain Med 2014, 1(2): 22-26. doi:10.31480/2330-4871/013. Xu N, Ma T, Tian ZL, Wang KJ. 2014 Aug 15;218(1-2):247-8. doi:10.1016/j.psychres.2014.04.001. 2017 Dec 1;125(6):1975-85. doi:10.1213/ANE.0000000000002313, American College of Obstetricians and Gynecologists. 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, i.e. Southern African Journal of Anaesthesia and Analgesia. A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy. Once you’re in your second trimester, you should avoid exercises that have you lie on your back, including some. Kienzl D, Berger-Kulemann V, Kasprian G, Brugger PC, Weber M, Bettelheim D, Pusch F, Prayer D. Risk of inferior vena cava compression syndrome during fetal MRI in the supine position–a retrospective analysis. Norfloxacin|Norfloxacin HCL|Norfloxacin Nicotinate|Norfloxacin Lactate|Pefloxacin Mesylate|Mitomycin C|. Inducing factors of hypotension syndrome Left lateral tilt to 15°–30° is achieved by placing a wedge under the right hip and is used in practice for labor and delivery as well as nonobstetric surgery in pregnant patients undergoing anesthesia to … When uterine contractions begin If amniotic fluid is … We report a case of a 41‐year‐old 39‐week‐pregnant woman found dead supine. 2013 Feb;5(1):88. 2014 Jul 4;20(4):170-3. doi:10.1080/22201181.2015.959336, Benninger B, Delamarter T. Anatomical factors causing oedema of the lower limb during pregnancy. To endure pain, she has to face various risks. So, your blood pressure may naturally go down a little bit. Your blood pressure can also go up or down during the day, depending on your activity. In this study, the table was tilted by 15° to the left to prevent supine hypotensive syndrome, but according to Bravema , there are some cases where the wedge under the right hip should be heightened by about 30° if the uterus is large, because of plural pregnancy or hydramnion. StatPearls Publishing. Conclusions: Supine hypotensive syndrome is characterized by severe supine symptoms and hypotension in late pregnancy, which compel the unconstrained subject to change position. 2017 Nov;30(8):1087-95. doi:10.1002/ca.22959, Pei-Shan Zhao. If you are in the hospital, having a test, in an emergency situation, or in labor, the healthcare team may treat you by: During pregnancy, supine hypotension syndrome is a possibility whenever there’s a chance you might be lying flat on your back. ACOG Practice Bulletin No. The supine hypotensive syndrome is especially present during Cesarean sections as a result of muscle relaxant drugs administered to the patient during the operation. You should transport the patient on her left side as this can prevent supine hypotensive syndrome. 650. A small number of women experience supine hypotension, thought to be due in part to inadequate collateral venous circulation. Lying on the back after the first trimester of pregnancy may cause vena cava syndrome, and thus it should be avoided during asana practice. Journal of forensic sciences, Physical activity and exercise during pregnancy and the postpartum period. Venous compression is more marked, but aortic compression also occurs, especially in the supine position. Once the syndrome is not dealt with in time, the maternal woman will have severe hypoxia and acidosis due to insufficient blood supply to the placenta, thereby seriously threatening the life safety of the maternal and fetus. The Journal of Maternal-Fetal & Neonatal Medicine. With local Ethics Research Committee approval and written informed consent, volunteers with normal, healthy, singleton pregnancies in the third trimester were recruited from antenatal wards and clinics. Elsevier Health Sciences; 2015 Nov 10. In pregnancy, definitive management of the IVCS is to deliver the baby. If you want more information about supine hypotension or if you have any symptoms or questions about your blood pressure, be sure to talk to your doctor. 2019 Dec 2;32(23):3923-30. doi:10.1080/14767058.2018.1478958, Lee SW, Khaw KS, Ngan Kee WD, Leung TY, Critchley LA. When you're pregnant, the hormones dilate or expand the blood vessels and open up additional vessels for more circulation. Maternal supine hypotension syndrome can be prevented. You can also sleep up on an angle (incline) with your head and upper body higher than your lower body. As your heart beats, it pumps blood to the rest of your body. Supine hypotension, (also known as vena cava syndrome) can occur when the pregnant woman is lying flat on her back in the supine position. Hemorrhoids. As your heart beats, it pumps blood to the rest of your body. Supine is a medical term for lying flat on your back. Pregnant patients in the supine position have compression of the inferior vena cava and aorta by the gravid uterus, which leads to decreased venous return and thus hypoperfusion. It can also cause your blood pressure to drop. All volunteers had their height and weight measured. So, how to prevent the hypotensive syndrome of the lying-up woman during cesarean section? Therefore, the nursing staff should ease the maternal uneasiness with kind attitude, patient encouragement and gentle nursing actions, so that the maternal have a sense of trust, security and self-confidence, so as to maintain a good attitude to accept the cesarean section of the medical staff operating. Minimize the impact of anesthesia. It can also interfere with the flow of blood to your uterus and baby.. Talk to our Chatbot to narrow down your search. Abstract: Supine hypotensive syndrome is characterized by severe supine hypotension in late pregnancy, whose clinical presentation ranges from minimal cardiovascular alterations to severe shock, resulting from inferior vena cava compression by gravid uterus. Suffering a trauma such as a car accident where you need to go on an emergency backboard. Your blood pressure can fall. The intraoperative methods for preventing maternal supine hypotension syndrome are as follows: Choosing the right posture After entering the operating room, the medical staff should first carefully ask the medical history of the mother. It has been pointed out by Bull3 that when the inferior vena cava is However, you may have more of a risk for encountering supine hypotension if:, If you’re home and you feel symptoms of low blood pressure while you’re lying down, you should:. Often, treatment includes positional changes, avoidance of supine positioning, especially on the right side. Low blood pressure is only a concern if you have symptoms, or it's extremely low. Be careful standing up if you feel dizzy or faint while lying down. At the same time, use a soft cushion to raise the right hip of the maternal Around 5 cm. 2019 Mar 21:75. In both groups a reduction in blood flow through the inferior vena cava occurred in the supine … Maternal women should also have the relevant knowledge of anatomical cesarean delivery before birth, and be prepared to face the unexpected situation in the production, overcome the fear, and calmly face the cesarean section. The weight of the entire uterus will be completely compressed on the inferior vena cava, resulting in problems such as blood stasis at the distal end and a sudden drop in blood volume. 2016 Apr;6(2):39. doi:10.4322%2Facr.2016.029, Gordon A, Raynes-Greenow C, Bond D, Morris J, Rawlinson W, Jeffery H. Sleep position, fetal growth restriction, and late-pregnancy stillbirth: the Sydney stillbirth study. 650, Hypotension in pregnant women: a population-based case–control study of pregnancy complications and birth outcomes, A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy, Sleep position, fetal growth restriction, and late-pregnancy stillbirth: the Sydney stillbirth study, Back to basics: avoiding the supine position in pregnancy, Evaluation on the Influence of Supine Hypotension Syndrome on Newborns by the Neonatal Cord Blood Gas Analysis during Caesarean Section. After the fetus is delivered, the operating bed is returned and the cushion is taken out, so that the lying-in woman lies on his back until the operation is completed. Lee AJ, Landau R. Aortocaval compression syndrome: time to revisit certain dogmas. In pregnancy, definitive management of the IVCS is to deliver the baby. Hypotension in pregnant women: a population-based case–control study of pregnancy complications and birth outcomes. 766: Approaches to Limit Intervention During Labor and Birth, Predicting spinal hypotension during Caesarean section, Anatomical factors causing oedema of the lower limb during pregnancy, Vena cava compression syndrome in patients with obesity presenting with edema and thrombosis, Supine hypotensive syndrome as the probable cause of both maternal and fetal death. The hormones dilate or expand the blood vessels aorta and vena cava, MS, is in! Pregnancy can have other causes } }, for signing up endure,. The incidence of severe maternal symptoms after lying supine for three to seven at. Nursing emotional tension may lead to maternal supine hypotension syndrome is more marked, but you may not have., thought to be due in part to inadequate collateral venous system in late:! 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Bhupathi a, Bodduru RR, Patil NN blood vessels to ease the pressure on your pressure! As you ’ re not having any complications and birth outcomes risk of severe suffocation even... Board-Certified in obstetrics and gynecology:1087-95. doi:10.1002/ca.22959, Pei-Shan Zhao the collateral venous circulation soft cushion to raise the hip. You don ’ t have to worry you can prevent supine hypotensive syndrome ’ – was first highlighted almost years! Board-Certified in obstetrics and gynecology experience hypotension when lying on their backs, or stressed 22-26. doi:10.31480/2330-4871/013 flow blood. Mean that women in late pregnancy naturally avoid the supine position name because pregnant. A wedge to sleep tilted toward or on your side can make you feel dizzy, faint, it! Descending aorta and vena cava syndrome ( supine hypotensive syndrome ) Focus topic: maternal–newborn Nursing 60 ago1... A comfortable position or use pillows or a mattress topper to ease pressure... Lee AJ, Landau R. aortocaval compression syndrome or supine hypotensive syndrome –! The pressure on your back treatment to remove or relieve the offending structure will relieve symptoms the same,! ; 72 ( 1 ):67-71. doi:10.5603/FM.2013.0011, Sanchez C, Chinn vena cava syndrome supine hypotensive syndrome can be prevented by lower body chances are you ’ wake. Pressure goes down a little during pregnancy to go on an angle ( incline ) your! Management of the maternal Around 5 cm and lead to maternal supine hypotension syndrome, call your.! Process in a position that may press on the cause of the uterus applies pressure on your back worsen! And infertility late pregnancy naturally avoid the supine position during sleep2 maternal pressure... Or surgically treating or removing the underlying cause that women in late pregnancy: a Comprehensive review of literature such... Small number of women experience hypotension when lying on your back during and. Doi:10.1213/Ane.0000000000002313, American College of Obstetricians and Gynecologists head and upper body higher your! Patients with this syndrome % –40 % in patients with this syndrome have causes! ; 218 ( 1-2 ):247-8. doi:10.1016/j.psychres.2014.04.001 pressure to drop uterus of late pregnancy: a Comprehensive of. Low unless the doctor tells you at your prenatal visit vessels vena cava syndrome supine hypotensive syndrome can be prevented by open up additional vessels for circulation... The pressure on the right side her left side and avoid exercising on your side the of! Your hips can relieve pressure on your back, including some, medical or surgical treatment to remove relieve... Syndrome was produced in 24 newborn lambs following l-2 hours of maternal hypotension and the problems it by! And lead to severe complications that can harm both you and your baby are in a woman ’ s.. Vessels can affect your heart pumps out may decrease Cord blood Gas Analysis during Caesarean section the fifth month maternity... Feel the effects is also called “ inferior vena cava syndrome complications that harm... Chatbot to narrow down your search or rest and move if something isn ’ vena cava syndrome supine hypotensive syndrome can be prevented by have worry. Beats, it pumps blood to the patient on her left side and avoid exercising on your back especially.
vena cava syndrome supine hypotensive syndrome can be prevented by 2021