{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:33:16Z","timestamp":1791027196054,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,29]],"date-time":"2019-12-29T00:00:00Z","timestamp":1577577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Supine positioning during late pregnancy causes the gravid uterus to compress the inferior vena cava, resulting in dramatic hemodynamic changes. The maintenance of placental perfusion requires maternal circulatory and autonomic adaptations. Women with supine hypotensive syndrome (defined as a drop in systolic blood pressure of anything between 15 and 30\u00a0mmHg or an increase in heart rate of 20 bpm, with or without symptoms) may have reduced ability to compensate for the effects of supine positioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Twelve women\u00a0with uncomplicated pregnancies and no symptoms of supine hypotension (normal) and 10 women with\u00a0uncomplicated pregnancies who reported\u00a0symptoms of supine hypotension between 34 and 38\u00a0weeks\u2019 gestation underwent magnetic resonance imaging in the supine and left lateral positions. Phase contrast images were evaluated to measure blood flow through the aorta, inferior vena cava, superior vena cava and azygos vein.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with symptoms of supine hypotension showed significant reductions in azygos venous flow rate compared with the normal group (\u22120.15 (\u22120.30 to \u22120.01)\u00a0L\/min). Those with symptoms showed no statistically significant compensatory changes in heart rate compared with the normal group (heart rate change 4.5 (\u22123.1 to 12.1) bpm).\u00a0Hemodynamic changes in response to positioning were similar across both groups including: a reduction in inferior vena cava blood flow, reduction in cardiac output and an increase in azygos blood flow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal hemodynamic adaptations were found to be consistent across groups irrespective of whether the women had symptoms of supine hypotension. In both groups a reduction in blood flow through the inferior vena cava occurred in the supine position with a subsequent reduction in cardiac output. Both groups showed a compensatory increase in blood flow through the azygos vein in order to partially compensate for this. Taking into account the effect of maternal position, women with symptoms were found to have reduced azygos flow compared with asymptomatic women. There was a significant increase in heart rate when the women were supine than when they were in the left lateral position.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13789","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T17:37:56Z","timestamp":1576777076000},"page":"631-636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Hemodynamic changes in women with symptoms of supine hypotensive syndrome"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-0964","authenticated-orcid":false,"given":"Aimee","family":"Humphries","sequence":"first","affiliation":[{"name":"Department of Anatomy and Medical Imaging The University of Auckland Auckland New Zealand"},{"name":"Department of Obstetrics and Gynecology The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed A.","family":"Mirjalili","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Medical Imaging The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2154-1143","authenticated-orcid":false,"given":"Gregory P.","family":"Tarr","sequence":"additional","affiliation":[{"name":"Department of Radiology Middlemore Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6944-381X","authenticated-orcid":false,"given":"John M. D.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The University of Auckland Auckland New Zealand"},{"name":"Department of Pediatrics: Child and Youth Health The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1546-752X","authenticated-orcid":false,"given":"Peter","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,29]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"371","article-title":"Supine hypotensive syndrome in late pregnancy","volume":"1","author":"Howard BK","year":"1953","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_3_1","first-page":"774","article-title":"Supine hypotensive syndrome","volume":"83","author":"Kinsella SM","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2012.02165.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1960.tb06987.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1965.tb00061.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bmb.a070587"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5382.522"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348309154222"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)90534-1"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-31"},{"key":"e_1_2_10_12_1","first-page":"1","article-title":"The effect of supine positioning on maternal hemodynamics during late pregnancy","volume":"4","author":"Humphries A","year":"2018","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127304"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22959"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179396"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000627"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14967"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d3403"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.01.013"},{"key":"e_1_2_10_20_1","volume-title":"Ethnicity Data Protocols for the Health and Disability Sector","author":"Ministry of Health","year":"2004"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(15)33723-6"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01056.x"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T09:32:55Z","timestamp":1694079175000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,29]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1111\/aogs.13789"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13789","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,29]]},"assertion":[{"value":"2019-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}