For a pregnant patient at 6 months gestation or more with trauma and spinal motion restriction indicated, which position is recommended?

• A. Left lateral decubitus with 30-degree tilt
• B. Supine with legs elevated
• C. Tilt the patient to the left 30 degrees
• D. Right lateral tilt 15 degrees

Answer: (C)

In late pregnancy, the enlarged uterus can press on the inferior vena cava when the patient is on their back, reducing venous return and uteroplacental perfusion. Even with spinal immobilization for trauma, you want to relieve that compression without compromising alignment. Tilting the patient to the left by about 30 degrees does just that: it moves the uterus off the IVC, improves blood return to the heart, and enhances fetal perfusion while keeping the spine in a stable, immobilized position. A right-side tilt won’t relieve the compression effectively, and staying supine can worsen maternal hypotension and fetal distress. So the recommended approach is a leftward tilt of roughly 30 degrees.