Abstract
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.
Das Dogma der 15°-Linksseitenlagerung im geburtshilflichen Setting ist fester Bestandteil
geburtshilflicher Praxis und Literatur sowie Teil aktueller Leitlinienempfehlungen
– aber ist es
auch sinnvoll?
Schlüsselwörter
15°-Linksseitenlagerung - Vena cava inferior - Geburtshilfe - Azygossystem
Keywords
15° left lateral tilt position - inferior vena cava - obstetrics - azygos
