During resuscitation of a pregnant trauma patient, why is left lateral tilt used?

• A. To relieve aortocaval compression and improve uteroplacental perfusion.
• B. To collect amniotic fluid.
• C. To facilitate intubation.
• D. There is no recommendation.

Answer: (A)

Relieving compression of the major vessels by the gravid uterus is the main idea. In late pregnancy, lying flat can press the uterus against the inferior vena cava and the abdominal aorta, which reduces venous return to the heart and lowers cardiac output, also diminishing placental blood flow. Placing the patient in a left lateral tilt displaces the uterus away from those vessels, improves venous return, increases maternal cardiac output, and enhances uteroplacental perfusion and fetal oxygen delivery during resuscitation. A tilt of about 15 to 30 degrees (often with a wedge under the right hip) is used to achieve this. The other options don’t address this vital hemodynamic benefit during resuscitation.