• Eur J Anaesthesiol · Feb 2024

    MRI of caval compression during left-lateral tilt in singleton and twin pregnancies: A prospective cohort study.

    • Nobuko Fujita, Hideyuki Higuchi, and Yuki Yonekura.
    • From the Department of Anaesthesia, St. Luke's International Hospital (NF), Department of Anaesthesia, Tokyo Shinagawa Hospital (HH) and Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan (YY).
    • Eur J Anaesthesiol. 2024 Feb 1; 41 (2): 122128122-128.

    BackgroundIt is unclear how different degrees of left-lateral tilt affect the volumes of the abdominal aorta and inferior vena cava (IVC) in pregnancy.ObjectiveTo use magnetic resonance images to assess the volumes of the abdominal aorta and IVC in women with twin or singleton pregnancies in different degrees of left-lateral tilt.DesignProspective cohort study.SettingA single-centre university hospital.PatientsWomen with singleton pregnancies (13) and twin pregnancies (13) at 32 to 38 weeks' gestation.Main Outcome MeasuresComparison of abdominal aortic and IVC volumes measured by MRI in women with singleton and twin pregnancies while in the supine or left-lateral tilt position at 15°, 30° and 45°.ResultsSupine, the mean aortic and IVC volumes were not significantly different between the women with singleton and twin pregnancies. In a left-lateral tilt position of 15 o compared with supine, the mean IVC volume was not increased in either group (singletons: 6.3 ± 6.6 ml, 95% CI, -2.4 to 0.4; P  = 0.174; twins: 3.9 ± 2.4 ml, 95% CI, -2.6 to 0.4; P  = 0.138). At tilt angles of 30° or 45°, the mean IVC volume significantly increased (singletons 30°: 9.7 ± 5.8 ml, 95% CI, -6.1 to -2.7; P  < .001; singleton 45°:13.8 ± 5.0 ml, 95% CI, -11.3 to -5.7; P  < .001; twins 30°: 5.7 ± 2.1 ml, 95% CI, -4.0 to -1.4; P  < .001; twins 45°: 12.8 ± 9.4 ml, 95% CI, -17.2 to -2.6; P  = 0.003). Aortic volume was not significantly increased in either group at any of the examined tilt angles compared with the supine.ConclusionIVC volume is significantly increased by 30° and 45° left-lateral tilt positions compared with supine in women with singleton and twin pregnancies.Trial RegistrationThis study was registered in the University Hospital Medical Information Network (UMIN) clinical trial registration (# UMIN000031273).Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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