Question

You are called to assist a pregnant female in the 24th week gestation period according to her due date. The pale 26-year-old patient is found supine in bed, complaining of dizziness/weakness with extreme nausea. The patient denies vaginal bleeding, amniotic fluid leakage, or abdominal pain. There are no signs of imminent birth or active labor. She reports receiving normal prenatal care with no associated problems found during the pregnancy. Her heart rate is 126-130 beats per minute; her blood pressure is 80 mmHg systolic while her skin is cool and pale. Which of the following conditions is most likely to cause the patient's presentation?

A) Uterine rupture

B) Spontaneous abortion

C) Supine hypotension

D) Placenta previ

Answer 1

The most likely cause of the symptoms is supine hypotension, a condition that occurs when the pregnant uterus compresses the inferior vena cava when the patient is lying flat, leading to reduced blood return to the heart and symptoms of dizziness and weakness.

Step-by-step explanation:

The condition most likely to cause the presentation of a pregnant female in her 24th week of gestation who is experiencing dizziness/weakness with extreme nausea, and who has a high heart rate and low blood pressure without signs of vaginal bleeding, amniotic fluid leakage, or abdominal pain, is C) Supine hypotension. Supine hypotension occurs when the pregnant uterus compresses the inferior vena cava when the patient is in the supine position. This compression can reduce the return of blood to the heart, leading to lowered blood pressure and symptoms like dizziness and weakness. The condition cannot be uterine rupture or spontaneous abortion, as these would likely present with pain and/or bleeding, and the question does not mention placenta previa, which is typically associated with painless vaginal bleeding.