In pregnant trauma patient with vena cava compression, what is the expected sign?

• A. Tachycardia and hypotension
• B. Bradycardia and hypertension
• C. Hypotension with tachypnea
• D. Hypertension without tachycardia

Answer: (A)

When a pregnant patient lies supine, the enlarged uterus can press on the inferior vena cava, reducing venous return to the heart. That drop in preload lowers cardiac output, so the body compensates with an increased heart rate. The combination of reduced preload and compensatory tachycardia leads to hypotension. This makes tachycardia with hypotension the expected sign in vena cava compression during pregnancy. Other patterns, like bradycardia with hypertension or hypertension without tachycardia, don’t fit the hemodynamic changes caused by vena cava compression. Tachypnea may occur later as shock develops, but the defining signs here are tachycardia and hypotension.