How important is Left side

Specialties Ob/Gyn

Published

How important is it to lay on your left side when resting? I have a friend who insists her midwife told her it was a semi wives tale. She is having a little PIH and may have PIH.

I know when I was on bed rest for this, it was a must!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Ummm sorry I did not read every post. I guess I said the same thing, just a bit more succinctly now that I read your post.

At least we agree, eh?

Ummm sorry I did not read every post. I guess I said the same thing, just a bit more succinctly now that I read your post.

At least we agree, eh?

oh ok!!! never mind !! yes we agree!!!! ginny :rotfl:

i think that as others have said ideally left is best. however, evidence has shown that statistically there is no different between right and left. i have searched a couple of my books and "lateral" is used and there is no differention between right and left. and anecdottally... during a decel and subsequent intrauterine resuscitation whichever side brings the hr up/eleviates variables is the best side for that mom.

below is a couple of abstracts i was able to pull up. i think the moral of this story is " nthe effects of maternal position and cardiac output on intrapulmonary shunt in normal third-trimester pregnancy.

hankins gd, harvey cj, clark sl, uckan em, van hook jw.

university of texas medical branch at galveston, usa.

objective: to assess the effect of pregnancy, maternal position, and cardiac output on intrapulmonary shunting (qs/qt) in normotensive nulliparous women near term. methods: ten normotensive nulliparas between 36 and 38 weeks' gestation underwent pulmonary artery catheterization (via the subclavian route) and radial artery canalization. baseline assessments were made with subjects in the left lateral recumbent position after a 30-minute stabilization period. measurements were obtained sequentially in the left lateral, right lateral, supine, knee-chest, sitting, and standing positions. each position change was followed by a 10-minute pre-measurement stabilization period. cardiac output was measured via the thermodilution technique. blood samples were obtained simultaneously from the pulmonary and radial arteries and analyzed in duplicate for oxygen content with a blood gas analyzer. qs/qt was calculated using the classic shunt equation. statistical analysis was performed by analysis of variance of repeated measures of qs/qt and maternal position. the relationship of qs/qt to maternal cardiac output was evaluated by the correlation coefficient. significance was defined as p

pmid: 8752233 [pubmed - indexed for medline]

ot supine"

j. a. thurlow and s. m. kinsellaf1

sir humphry davy department of anaesthesia, st. michael's hospital, bristol, uk

available online 6 may 2002.

abstract

acute fetal distress in labour is a condition of progressive fetal asphyxia with hypoxia and acidosis. it is usually diagnosed by finding characteristic features in the fetal heart rate pattern, wherever possible supported by fetal scalp ph measurement. intrauterine resuscitation consists of applying specific measures with the aim of increasing oxygen delivery to the placenta and umbilical blood flow, in order to reverse hypoxia and acidosis. these measures include initial left lateral recumbent positioning followed by right lateral or knee-elbow if necessary, rapid intravenous infusion of a litre of non-glucose crystalloid, maternal oxygen administration at the highest practical inspired percentage, inhibition of uterine contractions usually with subcutaneous or intravenous terbutaline 250 g, and intra-amniotic infusion of warmed crystalloid solution. specific manoeuvres for umbilical cord prolapse are also described. intrauterine resuscitation may be used as part of the obstetric management of labour, while preparing for caesarean delivery for fetal distress, or at the time of establishment of regional analgesia during labour in the compromised fetus. the principles may also be applied during inter-hospital transfers of sick or labouring parturients.

Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

Well, lets look at the comfort of the patient and the vitals that go along. Each person and each baby position will differ. Go with what works at the moment, ambulances are set up so that the patient turned on the left side will face the medic as that was the theory on best circulation for all instances.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Of course----comfort is indeed important, I don't think anyone is discounting that. But physiology backs up the rationale for using left-side positioning for increased perfusion of the kidneys. There are times when left-sided positioning actually makes things worse for the baby, usually due to cord positioning (e.g. in the case of nuchal cord). Obviously, you have to take each case individually, as you are dealing with individual patients , after all!

Specializes in Emergency Nursing Advanced Practice.
If she lies on her right side the baby can come to rest on and compress the vena cava and abdominal aorta. It would impede the flow of oxygenated blood to the rest of the body (and the baby). It would also impede venous return thus increasing her BP.

Nope, impeding venous return drops preload and drops BP, does not increase BP.

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