Which procedure may be placed supine with the right side elevated by a wedge to tilt left?

Which procedure may be placed supine with the right side elevated by a wedge to tilt left?

• A. Thyroidectomy
• B. Cesarean section
• C. Laminectomy
• D. Abdominoperineal resection

Answer: (B)

When a patient is in late pregnancy, lying flat can cause the enlarged uterus to press on the inferior vena cava and aorta, reducing blood return to the heart and affecting uteroplacental blood flow. Positioning with a wedge under the right hip creates a leftward tilt, which shifts the uterus away from those vessels and improves venous return and stability during surgery or anesthesia. This left-side tilt is commonly used for cesarean sections to maintain maternal hemodynamics and fetal oxygenation while the procedure is performed. Other procedures listed are typically carried out in positions that don’t require this specific right-side elevation to achieve left tilt—for example, thyroidectomy is done with neck extension, laminectomy is done prone, and abdominoperineal resection is done supine with the patient often in lithotomy or another setup.

When a patient is in late pregnancy, lying flat can cause the enlarged uterus to press on the inferior vena cava and aorta, reducing blood return to the heart and affecting uteroplacental blood flow. Positioning with a wedge under the right hip creates a leftward tilt, which shifts the uterus away from those vessels and improves venous return and stability during surgery or anesthesia.

This left-side tilt is commonly used for cesarean sections to maintain maternal hemodynamics and fetal oxygenation while the procedure is performed. Other procedures listed are typically carried out in positions that don’t require this specific right-side elevation to achieve left tilt—for example, thyroidectomy is done with neck extension, laminectomy is done prone, and abdominoperineal resection is done supine with the patient often in lithotomy or another setup.