Cardiac output-guided maternal positioning may protect the fetal oxygen supply and thereby reduce pregnancy complications.

Abstract

Chronic and recurrent obstruction of the inferior vena cava by the gravid uterus may be asymptomatic for the mother and yet contribute to preeclampsia, fetal growth restriction, preterm birth, dysfunctional labor and uterine atony. This previously unrecognized possible cause of chronic and recurrent fetal, placental and myometrial hypoxia might be detected and corrected using "cardiac output-guided maternal positioning," since positional obstruction of the inferior vena cava causes a positional decrease in maternal cardiac output (CO). These positional decreases in CO may therefore constitute an actionable warning signal for a pregnant woman to change her body position and thereby restore optimal uterine perfusion and fetal oxygenation. Continuous, non-invasive and hands-free trending of maternal CO is now feasible in real time in order to detect this warning signal in real time. Further research is required to evaluate this hypothesis, and if it is valid, the approach and therapy proposed might constitute a breakthrough for preventing some complications of pregnancy.