In pregnant patients, which position is recommended as a precaution during laparoscopy?

• A. Right lateral position
• B. Left lateral position (correct)
• C. Supine with Trendelenburg
• D. Prone

Answer: (A)

In pregnancy, particularly in the later stages, the uterus can press on the inferior vena cava when the patient is laid flat, reducing venous return and potentially compromising both maternal hemodynamics and fetal blood flow. Placing the patient in left lateral tilt (left lateral decubitus) shifts the uterus off the major vessels, improving venous return and uteroplacental perfusion during pneumoperitoneum for laparoscopy. A small wedge or a tilt of about 15 degrees is commonly used to achieve this position. Right lateral, supine with Trendelenburg, or prone positions do not alleviate the vessel compression and can worsen hemodynamic or respiratory status.