Hyperventilation-Induced Syncope with Transient Aphasia During Second-Stage Labor in a Primigravida with Severe Tokophobia.docx

We report a 28-year-old primigravida who developed syncope and transient aphasia during the second stage of labor under epidural analgesia. Comprehensive exclusion of organic causes (eclampsia, hemorrhage, drug toxicity) and psychometric confirmation of severe fear of childbirth (W-DEQ-B score: 104/165) support hyperventilation syndrome (HVS) as the primary etiology. This case underscores the critical intersection of psychosomatic triggers (anxiety-induced hypocapnia) and obstetric vulnerability. Integrating recent literature, we propose a multifactorial framework for intrapartum syncope, emphasizing that HVS accounts for 12–18% of unexplained labor collapses and requires distinct management from organic causes.