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Registered Nurse (RN)
Medical Surgical Nursing & Pathophysiology
Hypertension & Hypotension
Supine Hypotension (Vena Cava Syndrome)

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Supine Hypotension (Vena Cava Syndrome)

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Supine Hypotension (Vena Cava Syndrome)

Supine-spine Hippo-BP
Supine hypotension, (also known as vena cava syndrome) can occur when the pregnant woman is lying flat on her back in the supine position. The weight of the uterus applies pressure on the descending aorta and vena cava. This pressure decreases the woman’s blood pressure causing faintness, dizziness, breathlessness, clammy skin, sweating, tachycardia, and pallor. If supine hypotension occurs, the pregnant woman should lie on her side until symptoms subside.
Compression of the Vena Cava and Descending Aorta
Compressing Vine Cave and Descending A-orca

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.


Decreased blood pressure occurs due to compression of the vena cava and descending aorta, reducing blood return to the right atrium.


Due to decreased blood pressure and diminished blood return to the heart the woman in the supine position will feel faint and light headed. This may result in pallor, nausea, and clammy skin.


Due to decreased blood pressure and blood return to the right atrium, the heart compensates by pumping faster to circulate blood.

Decreased Renal Perfusion
Down-arrow Kidney Pear-fuse

As the uterus compresses the vena cava and descending aorta, blood pressure decreases and blood flow to the kidneys is interrupted.

Decreased Uteroplacental Perfusion
Down-arrow Uterus-placenta-present Pear-fuse

As blood pressure decreases due to pressure on the vena cava, the blood flow to the placenta is reduced thereby interrupting blood flow to the fetus.

Side-lying Position
Side-lying Position

Position the woman on her side until vital signs normalize and the signs and symptoms resolve. Side-lying position removes the pressure on the vena cava and aorta and allows blood to flow normally again. In addition, alternating between right and left side-lying positions provides abdominal and back support to promote comfort.


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