Published online by Cambridge University Press: 01 August 2014
In 33 out of 51 women studied in late gestation, the uterus was found to phasically compress the pelvic vessels and impede the venous blood flow during quiet standing. This caused a reduction of the cardiac stroke volume with resultant reduction of systemic blood pressure and a compensatory increased heart rate (range of increases 9-51 beats/min). In all cases uterine contractions (mostly subclinical) coincided with the phase of circulatory readjustment. Apparently, the contracting uterus, by changing its position and/or shape, relieves the venous obstruction and prevents decompensation. In the women displaying the uterine compression syndrome (UCS), uterine activity was markedly increased in standing compared to the left recumbent position.
It was also investigated whether the UCS appeared more often and earlier in gestation in women with twins. In all 9 women with twin pregnancies (mean gestational age 28 5/7 weeks) the UCS associated with uterine contractions was apparent in the standing posture. Although at present no definite conclusions can be reached on the effect on the cervix of these contractions, quiet standing especially in twin pregnancies seems to provoke an increased uterine activity and should therefore be avoided.