Supine Hypotensive Syndrome as the Probable Cause of Both Maternal and Fetal Death |
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| Authors: | Fabio De‐Giorgio MD PhD Vincenzo M Grassi MD Giuseppe Vetrugno MD PhD Ernesto d’Aloja MD PhD Vincenzo L Pascali MD PhD Vincenzo Arena MD PhD |
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| Institution: | 1. Institute of Legal Medicine, Catholic University, Medical School, Rome, Italy.;2. Department of Public Health, Forensic Medicine Section, Cagliari University, Cagliari, Italy.;3. Institute of Pathologic Anatomy, Catholic University, Medical School, Rome, Italy. |
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| Abstract: | Abstract: Supine hypotensive syndrome is characterized by severe supine hypotension in late pregnancy, whose clinical presentation ranges from minimal cardiovascular alterations to severe shock, resulting from inferior vena cava compression by gravid uterus. We report a case of a 41‐year‐old 39‐week‐pregnant woman found dead supine. Autopsy revealed the following: cyanosis of the limbs; congestion of the jugular and subclavian veins; abundant abdominal subcutaneous fatty tissue; uterus displacing intestine and diaphragm; collapsed inferior vena cava; both femoral veins dilated and filled with blood; edematous and congested lungs; and placenta 790 g, fetus 3475 g, amniotic fluid 800 cm3. The diagnosis of supine hypotensive syndrome as the probable cause of death is supported by the position of the body and autopsy findings. This syndrome can be considered as the first stage of the physio‐pathological mechanism that led to death in the case presented herein and should be considered by pathologists as a cause of sudden death. |
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| Keywords: | forensic science forensic pathology sudden death maternal death fetal death forensic autopsy supine hypotensive syndrome pregnancy |
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