Vena cava syndrome in pregnancy presents with which symptom cluster?

• A. Hypotension, dizziness, nausea, tachycardia
• B. Hypertension, facial edema, bradycardia
• C. Headache, fever, rash
• D. No symptoms

Answer: (A)

When the pregnant person lies on the back in late gestation, the enlarged uterus can compress the inferior vena cava, reducing venous return to the heart. This drop in preload lowers cardiac output and arterial pressure, producing hypotension. The body responds with tachycardia to try to maintain perfusion, and the reduced blood flow to the brain and GI tract leads to dizziness and nausea. This combination—hypotension, dizziness, nausea, and tachycardia—is the classic symptom cluster of vena cava syndrome in pregnancy, especially in the third trimester.

Relief comes from repositioning to the left lateral side (or a left-tilt/semi-recumbent position) to relieve the compression and improve venous return. Monitor vitals and symptoms, and avoid prolonged supine positioning. If symptoms persist or worsen, seek urgent assessment.