For a pregnant patient at or beyond six months, with spinal motion restriction indicated, what positioning adjustment is recommended?

For a pregnant patient at or beyond six months, with spinal motion restriction indicated, what positioning adjustment is recommended?

• A. Tilt the patient to the left 30 degrees
• B. Tilt the patient to the right 15 degrees
• C. Place the patient flat on their back
• D. Position the patient in a Trendelenburg tilt

Answer: (A)

In a patient who is six months pregnant or more and has a suspected spinal injury, the main idea is to relieve the uterus’s pressure on the inferior vena cava to improve venous return and placental perfusion while keeping the spine stabilized. Tilting the patient to the left about 30 degrees accomplishes this best. The left lateral tilt shifts the uterus off the major abdominal vessels, boosting maternal cardiac output and fetal oxygen delivery without removing spinal immobilization. Tilting to the right does not relieve the compression and can still compromise venous return. Lying flat on the back worsens aortocaval compression, reducing both maternal and fetal perfusion. A Trendelenburg position (head-down) worsens diaphragmatic excursion and venous return issues and is not appropriate in this scenario.

In a patient who is six months pregnant or more and has a suspected spinal injury, the main idea is to relieve the uterus’s pressure on the inferior vena cava to improve venous return and placental perfusion while keeping the spine stabilized. Tilting the patient to the left about 30 degrees accomplishes this best. The left lateral tilt shifts the uterus off the major abdominal vessels, boosting maternal cardiac output and fetal oxygen delivery without removing spinal immobilization.

Tilting to the right does not relieve the compression and can still compromise venous return. Lying flat on the back worsens aortocaval compression, reducing both maternal and fetal perfusion. A Trendelenburg position (head-down) worsens diaphragmatic excursion and venous return issues and is not appropriate in this scenario.