Why the study?
Positioning third-trimester pregnant patients in a 15° left lateral tilt to reduce IVC compression is longstanding practice, but recent MRI data challenge this traditional dogma.
Does a 15° left lateral tilt position reduce inferior vena cava compression in pregnant patients in their third trimester?
Does a 15° left lateral tilt position reduce inferior vena cava compression in pregnant patients in their third trimester?
The traditional practice of a 15° left lateral tilt to prevent IVC compression in third-trimester pregnancy is ineffective and should be replaced by proven measures like volume coloading and vasopressors.
Positioning 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.
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Massoth et al. (2022) studied this question.
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