Studies of the Inferior Vena Cava in Late Pregnancy

Kerr, M. G.; Scott, D.B.; Samuel, Eric

doi:10.1097/00006254-196408000-00002

Cited by 45 publications

(61 citation statements)

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“…13,14 Postural changes demonstrated during pregnancy are hypotension due to compression of the aorta and vena cava by the gravid uterus. [26][27][28] Right or left lateral positions compared to supine positions have demonstrated variability in subjective and objective responses. 29,30 Hypotension in the presence of neuraxial anaesthesia may be particularly marked and prevention and treatment of this may involve postural changes although studies specifically examining this intervention are small.…”

Section: Discussionmentioning

confidence: 99%

Prospective observational study of serial cardiac output by transthoracic echocardiography in healthy pregnant women undergoing elective caesarean delivery

Dennis

Arhanghelschi

Simmons

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Prospective observational study of serial cardiac output by transthoracic echocardiography in healthy pregnant women undergoing elective caesarean delivery

Dennis

Arhanghelschi

Simmons

et al. 2010

International Journal of Obstetric Anesthesia

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“…Firstly, the situation betw een contractions. In the horizontal position there is an obstruction of the vena cava and the blood circumvents this blockage via the collateral paravertebral veins; noted are the average blood pressures we observed (7,8). The next picture shows the situation during contractions.…”

Section: Block Probably Removedmentioning

confidence: 75%

Abdominal Decompression During the First Stage of Labor. On the Genesis of Birth Pains

Lukas

Dolezal

1968

Journal of the International Federation of Gynaecology and Obst

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“…A small proportion of women (8%) experience symptoms and signs of supine hypotensive syndrome when they adopt the supine position (Holmes, 1960;Kinsella and Lohmann, 1994). It has been suggested that this is due, in part, to inadequate collateral venous return (Scott and Kerr, 1963;Kerr et al, 1964;Kerr, 1965). Acute obstruction of the IVC requires rapid filling of the collateral venous system in order to maintain adequate circulation, of which the azygos system and the VVP are known to be the dominant pathways.…”

Section: Discussionmentioning

confidence: 99%

“…Later, a series of caval angiograms showed complete obstruction of the IVC with diversion of contrast into the ascending lumbar veins (ALV) and vertebral venous plexus (VVP). The authors concluded that these collateral pathways must provide adequate circulation in the supine position (Kerr et al, 1964). However, there have been no subsequent attempts to explore this in more detail.…”

Section: Introductionmentioning

confidence: 99%

The collateral venous system in late pregnancy: A systematic review of the literature

2017

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Recent literature has reported an association between maternal supine sleep position and stillbirth during late pregnancy. In this position the gravid uterus almost completely obstructs the inferior vena cava. A small number of women experience supine hypotension, thought to be due in part to inadequate collateral venous circulation. The aim of this paper is to review the literature describing the anatomy of the collateral venous system and in particular the azygos system, the abdominal portion of which has not been well studied. A systematic review was conducted using the electronic databases: Medline, Embase, Scopus, and Google Scholar. Relevant anatomical and radiological literature concerning the azygos system in particular was reviewed. The search was limited to adult human studies only. The collateral venous system can be divided into superficial, intermediate and deep systems. The azygos system in particular provides immediate collateral venous circulation in the event of acute inferior vena caval obstruction. The abdominal portion of this pathway, including the ascending lumbar vein, has not been well studied and there are certain variations that can render it ineffective. In conclusion, the collateral venous system provides an alternative route for blood to flow back to the systemic circulation when acute occlusion of the inferior vena cava occurs in the supine position during late pregnancy. However, certain anatomical variations can render this pathway ineffective, and this could have implications for the development of supine hypotension and stillbirth in late pregnancy. Clin. Anat. 30:1087-1095, 2017. © 2017 Wiley Periodicals, Inc.

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Studies of the Inferior Vena Cava in Late Pregnancy

Cited by 45 publications

References 0 publications

Prospective observational study of serial cardiac output by transthoracic echocardiography in healthy pregnant women undergoing elective caesarean delivery

Prospective observational study of serial cardiac output by transthoracic echocardiography in healthy pregnant women undergoing elective caesarean delivery

Abdominal Decompression During the First Stage of Labor. On the Genesis of Birth Pains

The collateral venous system in late pregnancy: A systematic review of the literature

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