Neonatal Acid-base Status Before and After Discontinuing Routine Left Uterine Displacement for Elective Cesarean Delivery: A Retrospective Cohort Study (2014–2017)

( Int J Obstet Anesth . 2025;62:104350 doi: 10.1016/j.ijoa.2025.104350) For decades, obstetric anesthesia guidelines have recommended maintaining left uterine displacement (LUD) during cesarean delivery (CD) to reduce aortocaval compression. This position was assumed to improve maternal hemodynamics and neonatal outcomes by preventing compression of the inferior vena cava and aorta by the gravid uterus. However, supporting evidence has been inconsistent, often based on nonrandomized studies with mixed anesthetic techniques and limited use of vasopressors. Imaging studies suggest that the aorta is rarely compressed in the supine position, while LUD provides only minimal relief of vena cava obstruction. Moreover, it is often observed that the clinically prescribed 15-degree tilt is rarely achieved in practice, raising questions about the actual utility of this maneuver.