Vena-Cava Compression Syndrome

definition

At the Vena-Cava-Compression syndrome is classically a complication in pregnancy that can occur especially towards the end. The child in the uterus presses on the inferior vena cava, the large inferior vena cava. In our body, it has the task of ensuring the return of blood from the legs and the abdominal organs.

If the vein is squeezed by the weight of the child, the first consequence is that the amount of blood that reaches the heart drops rapidly. This then leads to various circulatory-related problems, which can usually be remedied quickly by repositioning the expectant mother.

Even if the vena cava compression syndrome usually not a serious complication represents, affected women should be informed and the people around them should be informed in appropriate emergency situations. Because even if it is not the norm, the clamping of the vein can affect both the mother and the child life threatening be.

The following topic could also be of interest to you:

Pregnancy complications and Dizziness during pregnancy

causes

The cause of vena cava compression syndrome in most cases is one pregnancy. In the last three months in particular, the baby will grow to a stately size and gain more and more weight. The uterus expands and increasingly displaces the surrounding organs and structures - possibly including the inferior vena cava.

Veins are naturally elastic and thin-walled. In contrast to the arteries in which the oxygen-rich and nutrient-rich blood flows to supply the body, they are easy to squeeze. In addition, the blood pressure in the veins is many times lower than in the arterial system. All of these factors contribute to the fact that the vessel can already be pulled off by the weight of a baby.

In rare cases no child is the cause of vena cava compression syndrome, for example if a man suffers from corresponding symptoms. Other structures can also press on the inferior vena cava. Anyone can be considered Space claims in the abdomen, such as cysts, abscesses, organ enlargements as part of specific diseases, an abdominal aortic aneurysm or a growing tumor. Whenever the clinical picture of vena cava compression syndrome shows up, the first thing to do is doctor must be visited so that the exact cause can be clarified.

diagnosis

The diagnosis of vena cava compression syndrome is mainly based on the specific symptoms. In most cases, women are affected in the last three months of their pregnancy, who have problems with their circulation, mainly when lying down. The pregnant woman should first try one if symptoms are pronounced Change of position to carry out. If the circulatory problems then disappear and do not occur in the corresponding situation, this is a very clear sign of a vena cava compression syndrome.

To confirm the diagnosis, the attending gynecologist can use Ultrasonic assess the situation in the stomach. Under certain circumstances it can even be observed in this way how the uterus pushes the vein. Is the patient not pregnant or is it one man, a comprehensive diagnosis with imaging procedures and laboratory tests should be initiated in order to track down the cause.

Symptoms

The symptoms that occur in vena cava compression syndrome are due to the lack of blood that occurs in the heart as a result of the clamping. There is no longer enough volume, which also reduces the release of new, oxygen-rich blood. So the blood pressure drops rapidly and one occurs Circulatory crisis.

The first thing the patient notices is sudden dizziness. In this way, the brain draws attention to the fact that there is not enough oxygen available. The next step can be impaired consciousness or even fainting. If this happens, action must be taken quickly to prevent consequential damage to mother and child.

The heart tries to compensate for the reduced blood output with a faster frequency, which is why the heart races.It also causes deep and heavy breathing because the body does not know that the lack of oxygen is not due to a lung problem. Due to its short duration, the lack of oxygen rarely leads to damage to the mother, but it can have serious consequences for the growing child. The worst comes to a so-called fetal hypoxia (child's lack of oxygen), which not only causes premature birth, but also late-stage damage to the baby.

The following topic could also be of interest to you:

Pregnancy complications and Dizziness during pregnancy

Treatment / therapy

As frightening as the symptoms of Vena Cava Compression Syndrome may sound, the acute treatment of the disease is usually easy, at least for pregnant women - if the lesion has a different cause, the therapy can be more extensive and require surgical intervention.

Since the symptoms of pregnant women mainly occur in the supine position and thus the entire weight of the uterus and the child rest on the inferior vena cava, one is usually enough slight lateral position. Due to the anatomical features, the patient should to the left be rotated. This is because the inferior vena cava runs close to the spine on the right side of the body.

At Left lateral position So the vessel is relieved and the symptoms should go away almost immediately. Often this tip is enough to make further treatment unnecessary. The pregnant woman often notices by herself when the symptoms begin and can then turn on her side without authorization. In addition to the expectant mother, the environment should also be trained in this regard. For example, the father can also actively intervene if the pregnant woman faints.

If the repositioning does not bring about any relevant improvement in the condition, an emergency doctor must be alerted immediately. This is followed by admission to the nearest intensive care unit, where an attempt is then made to stabilize the circulation by administering fluids. In rare cases, a caesarean section must be performed to protect the mother.

Read more on this topic at: Dizziness when lying down and fainting (during pregnancy)

Left lateral position

As already described, lying on the left side is the therapy of choice for vena cava compression syndrome. The inferior vena cava is next to the spine on the right side of the abdomen. So to relieve the burden a Storage on the opposite side be performed. The patient only needs to turn or roll over from her back to her left side. Often an incline of around 45 degrees is sufficient.

To ensure that the position is still comfortable and the sleeping position stable, a 90 degree turn can of course also be performed. There are also special side pillows that many pregnant women already have to use because of problems with a baby bump in bed.

In addition, a pillow or blanket can be placed in the back so that the person concerned does not roll back again at night. This relatively simple procedure allows the vena cava compression syndrome to remain asymptomatic in many cases. However, it must always be noted that immediate relief cannot always be expected from storage and in this case immediately doctor to be contacted.

Time of onset in vena cava compression syndrome

There is no specific point in time during pregnancy as to when Vena-Cava Compression Syndrome traditionally occurs. However, it can be said that the disease occurs in the third trimester, that is, in the third part of pregnancy - in the last three months.

Whether and how severely the syndrome occurs is decisively influenced by the size of the child, the weight and the position of the uterus before the pregnancy. The position of the child may also play a role and whether the mother has any anatomical peculiarities.

In terms of pregnancy weeks, vena cava compression syndrome is most likely to occur between the 29th and 40th week of pregnancy. The information that premature births from the 26th week of pregnancy are classified as viable and that an early termination of pregnancy does not necessarily have to be a disadvantage for the child is reassuring.

The following article may be of interest to you: Course of pregnancy and premature birth

Other situations of occurrence

In stand

The vena cava compression syndrome is usually only described in the specialist literature while lying down. However, pregnant women occasionally report having symptoms as well while sitting or even in stand occur.

This can also be “only” a vena cava compression syndrome, which is very pronounced and can become a serious burden for the pregnant woman. Those affected usually have no choice but to try to survive the rest of the pregnancy unscathed.

As part of this, it is likely that the expectant mother will stop her work and hers physical activity must reduce to a minimum. Also, someone should always be present as it can lead to more falls. If the situation becomes unbearable or if the patient's health is too endangered, early delivery may need to be considered. Other causes of vena cava compression syndrome should also be ruled out.

While sitting

The vena cava compression syndrome can be felt not only in the lying position, but also when sitting. Even if this is much less the case, the symptoms lead to extensive restrictions in the patient's everyday life.

For example, the job normally practiced can no longer be carried out effectively. Above all a Office job represents a major hurdle in which either working hours should be shortened or even sick leave must be taken. Eating at the table can also be a problem.

Some pregnant women describe symptomatic relief when their legs are raised. Others have to eat their food in a (half) lying position. As with every pregnancy complication, the following also applies here: if the health of the expectant mother is too seriously endangered, it is essential to think about ending the pregnancy prematurely and to bring the child earlier.