Author:
Massoth Christina,Kranke Peter,Wenk Manuel
Abstract
AbstractPositioning the pregnant patient in her third trimester in a 15° left lateral tilt position with the rationale to reduce inferior vena cava (IVC) compression is a longstanding practice of
both obstetric and anesthesia care. Recent data from MRI imaging studies have challenged this traditional dogma, since the IVC was found to remain compressed at a 15° angle, with a tilt of
at least 30° necessary to provide a certain relief of the vessel. However, even the 15° tilt is regularly underestimated by visual judgement and improperly executed, but comes with several
disadvantages without adding any benefit on fetal outcome. Current evidence supports all efforts to cease the dogma of a 15° left lateral position for its lack of effectiveness and instead
put emphasis on proven measures, such as volume coloading and the timely administration of vasopressors.
Subject
Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine,Emergency Medicine,General Medicine