In trauma during pregnancy, what position is recommended to avoid supine hypotension syndrome?

• A. Keep patient in left lateral decubitus position
• B. Place wedge under left hip
• C. Right lateral decubitus position
• D. Supine with no adjustment

Answer: (A)

In late pregnancy, lying flat can compress the inferior vena cava and aorta under the uterus, reducing venous return to the heart and placental blood flow. The way to prevent this is to tilt the patient so the uterus moves off the major vessels. The left lateral decubitus position accomplishes this, maximizing venous return and improving both maternal hemodynamics and fetal perfusion. In practice, a leftward tilt can be achieved by placing a wedge under the right hip, which effectively recreates the left lateral position. A wedge under the left hip would tilt the patient toward the right, not relieve the compression. Right lateral decubitus or remaining supine keeps the vascular compression and is not advised.