Supine Hypotensive Syndrome as the Probable Cause of Both Maternal and Fetal Death

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 790g, fetus 3475g, amniotic fluid 800cm 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. © 2012 American Academy of Forensic Sciences.