• Left-lateral tilt, aortocaval compression and caesarean section

     
       

    Daniel Jolley.

    9 articles.

    Created October 24, 2018, last updated over 1 year ago.


    Collection: 92, Score: 1112, Trend score: 0, Read count: 1112, Articles count: 9, Created: 2018-10-24 23:40:40 UTC. Updated: 2021-02-09 00:08:21 UTC.

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    Is the conventional assumption that left-lateral tilt and uterine displacement avoids aortocaval compression during Caesarean section actually valid?

    50 years of assumed orthodoxy is challenged by studies showing that:

    • True aortal compression is relatively uncommon (Higuchi 2015, Lee 2012).
    • Caval compression is probably near-universal, but also usually not improved by a mere 15 degree tilt. (An impractical 30 degrees is more likely required for meaningful impact!) (Palmer 2015).
    • Caval compression probably has limited haemodynamic or fetal consequences in the fit, well, term parturient (Higuchi 2015; Lee 2012).
    • Judicious use of vasopressor infusions may obviate the need for traditional uterine displacement (Lee 2017; Farber 2017).

    Time to change practice then?

    Not quite yet...

    Daniel Jolley  Daniel Jolley
     
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