INI-CET 2017 — Obstetrics and Gynecology

Question 1: A pregnant lady was admitted with diagnosis of PIH for monitoring and bed rest. When lying in supine position, which of the following complications is depicted in the image below?

• A. Abdominal aorta syndrome
• B. Supine venocaval syndrome (Correct Answer)
• C. Ascending aorta syndrome
• D. Superior vena cava syndrome

Explanation: ***Supine venocaval syndrome*** - The image depicts a pregnant woman lying in a **supine position**, where the **gravid uterus** compresses the **inferior vena cava (IVC)** and potentially the aorta against the vertebral column. - This compression of the IVC leads to reduced venous return to the heart, causing a drop in cardiac output and blood pressure, known as **supine venocaval syndrome** or **aortocaval compression syndrome**. *Abdominal aorta syndrome* - While the aorta can also be compressed in the supine position by the gravid uterus, symptoms primarily arise from **venous compression (IVC)** due to its lower pressure, which is more easily obstructed. - Significant symptoms solely from **aortic compression** are less common than those from IVC compression. *Ascending aorta syndrome* - The **ascending aorta** is located in the chest, not in the abdomen, and would not be compressed by the gravid uterus. - This condition generally refers to issues like ascending aortic aneurysm or dissection, unrelated to uterine compression. *Superior vena cava syndrome* - **Superior vena cava (SVC) syndrome** results from obstruction of the SVC, typically by **mediastinal tumors** or **thrombosis**. - The SVC is in the upper chest and is not affected by the gravid uterus in a supine position.