In third trimester complications such as placenta abruptio/placenta previa/uterine rupture, what is the recommended patient positioning to improve perfusion?

In third trimester complications such as placenta abruptio/placenta previa/uterine rupture, what is the recommended patient positioning to improve perfusion?

• A. Supine with legs elevated
• B. Left lateral decubitus with no tilt
• C. Transport on the left side with the right side elevated 4-6 inches
• D. Trendelenburg position

Answer: (C)

Relieving aortocaval compression from the enlarged uterus is the key idea. In the late stages of pregnancy, lying flat can press on the inferior vena cava and aorta, reducing venous return and placental blood flow. Positioning the patient on the left side helps move the uterus away from these vessels, and elevating the right side 4–6 inches adds a slight leftward tilt that further relieves compression. This combination improves maternal blood pressure and uteroplacental perfusion, which is especially important in third-trimester complications like placental abruption, placenta previa, or uterine rupture. The other positions either maintain vessel compression or worsen it (for example, supine or Trendelenburg), so they are less effective for optimizing perfusion.

Relieving aortocaval compression from the enlarged uterus is the key idea. In the late stages of pregnancy, lying flat can press on the inferior vena cava and aorta, reducing venous return and placental blood flow. Positioning the patient on the left side helps move the uterus away from these vessels, and elevating the right side 4–6 inches adds a slight leftward tilt that further relieves compression. This combination improves maternal blood pressure and uteroplacental perfusion, which is especially important in third-trimester complications like placental abruption, placenta previa, or uterine rupture. The other positions either maintain vessel compression or worsen it (for example, supine or Trendelenburg), so they are less effective for optimizing perfusion.