Syncope gravidarum: differential diagnosis and obstetric implications - an integrative review

Abstract

Introduction: Syncope gravidarum is a recurrent clinical manifestation during pregnancy and can be associated with both normal physiological changes and potentially serious underlying conditions. Proper differential diagnosis is essential to avoid maternal and fetal complications. This study aims to review the literature on the main causes, obstetric implications and management strategies for syncope in pregnancy. Methodology: This is an integrative literature review carried out on the LILACS, SciELO, PubMed and Scopus databases. The descriptors “Syncope”, “Orthostatic hypotension” and “Pregnancy” were used, combined with Boolean operators. Nine studies published between 2020 and 2025 that met the inclusion criteria were analyzed. Results and Discussion: The findings indicate that syncope during pregnancy can be caused by benign factors, such as orthostatic hypotension and vasovagal syncope, or by serious conditions, such as arrhythmias and pulmonary thromboembolism. Early identification of the etiology is essential to prevent complications, including falls, fetal hypoxia and intrauterine growth restriction. Clinical management involves detailed assessment, complementary tests and continuous monitoring of the pregnant woman. Preventive strategies, such as adequate hydration and postural changes, are effective in reducing the recurrence of episodes. In the most serious cases, a multidisciplinary approach involving cardiologists and obstetricians is essential to ensure maternal and fetal safety. Conclusion: Syncope gravidarum requires careful investigation to differentiate benign causes from potentially lethal conditions. Evidence-based protocols are essential for safe management, reducing risks and promoting better maternal-fetal outcomes. Further studies are needed to improve clinical guidelines and optimize obstetric care.