A healthy 25-year-old G1P0 at 37 weeks’ gestational age comes to your office to see you for a routine obstetric visit. She reports that on several occasions she has experienced dizziness, light-headedness, and feeling as if she is going to pass out when she lies down on her back to take a nap.
What is the most appropriate plan of management for this patient?
A. Perform an electrocardiogramLate in pregnancy, when the mother assumes the supine position, the gravid uterus compresses the inferior vena cava and decreases venous return to the heart. This results in decreased cardiac output and symptoms of dizziness, light-headedness, and syncope. This significant arterial hypotension resulting from inferior vena cava compression is known as supine hypotensive syndrome or inferior vena cava syndrome. Therefore, it is not recommended that women remain in the supine position for any prolonged period of time in the latter part of pregnancy. When patients describe symptoms of the supine hypotensive syndrome, there is no need to proceed with additional cardiac or pulmonary workup.