A 25 year old female was the driver of a car that struck a telephone pole. She is 30 weeks pregnant. During transport, she becomes pale and hypotensive. What should you do?

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Multiple Choice

A 25 year old female was the driver of a car that struck a telephone pole. She is 30 weeks pregnant. During transport, she becomes pale and hypotensive. What should you do?

In late pregnancy, the uterus can press on the inferior vena cava when a patient is lying flat, which reduces return of blood to the heart and drops blood pressure. Moving her to the left side relieves that compression, increases venous return, and improves both her and the fetus’s perfusion. This is the most immediate way to reverse the shock state seen here during transport. If full left-sided positioning isn’t possible, a left tilt (placing a wedge under the right hip) provides the same benefit. After establishing this position, you’d continue with supportive care such as oxygen and IV access, but the key fix is relieving the vena cava compression by left-sided positioning.

In late pregnancy, the uterus can press on the inferior vena cava when a patient is lying flat, which reduces return of blood to the heart and drops blood pressure. Moving her to the left side relieves that compression, increases venous return, and improves both her and the fetus’s perfusion. This is the most immediate way to reverse the shock state seen here during transport. If full left-sided positioning isn’t possible, a left tilt (placing a wedge under the right hip) provides the same benefit. After establishing this position, you’d continue with supportive care such as oxygen and IV access, but the key fix is relieving the vena cava compression by left-sided positioning.

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