De-Giorgio Fabio, Grassi Vincenzo M, Vetrugno Giuseppe, d'Aloja Ernesto, Pascali Vincenzo L, Arena Vincenzo
Institute of Legal Medicine, Catholic University, Medical School, Rome, Italy.
J Forensic Sci. 2012 Nov;57(6):1646-9. doi: 10.1111/j.1556-4029.2012.02165.x. Epub 2012 Apr 26.
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 cm(3). 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.
仰卧位低血压综合征的特征是妊娠晚期出现严重的仰卧位低血压，其临床表现从轻微的心血管改变到严重休克不等，是由妊娠子宫压迫下腔静脉所致。我们报告一例41岁、孕39周的仰卧位死亡孕妇病例。尸检发现如下：四肢发绀；颈静脉和锁骨下静脉淤血；腹部皮下脂肪丰富；子宫推移肠管和膈肌；下腔静脉塌陷；双侧股静脉扩张且充满血液；肺淤血水肿；胎盘790克，胎儿3475克，羊水800立方厘米。尸体位置和尸检结果支持将仰卧位低血压综合征作为可能的死因诊断。该综合征可被视为本文所述病例导致死亡的生理病理机制的第一阶段，病理学家应将其视为猝死原因之一。
