Trauma and burns: positioning of the pregnant trauma patient: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma and burns: positioning of the pregnant trauma patient

Sample item

A woman at 32 weeks of gestation is brought after a road accident. Lying supine on the trolley, she is pale with a blood pressure of 85/50 mmHg that improves when the trolley is tilted. What is the best immediate measure?

AKeep her flat with a head-down tiltBPlace her in the right lateral positionCTilt her to the left or manually displace the uterus to the leftDApply a pelvic binder to compress the uterus

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Tilt her to the left or manually displace the uterus to the left

From about 20 weeks, the gravid uterus can compress the inferior vena cava and aorta in the supine position, reducing venous return and cardiac output. Left lateral tilt or manual displacement of the uterus relieves compression, while resuscitation continues. Spinal precautions are kept with a tilted board.

Option by option

A. Keep her flat with a head-down tilt
Head-down tilt does not relieve caval compression, and may worsen breathing.
B. Place her in the right lateral position
The right side moves the uterus onto the vena cava, because the cava lies on the right.
C. Tilt her to the left or manually displace the uterus to the left (correct)
Correct. Left uterine displacement relieves aortocaval compression and restores venous return.
D. Apply a pelvic binder to compress the uterus
A pelvic binder does not treat the supine hypotensive syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Tilt her to the left or manually displace the uterus to the left. From about 20 weeks, the gravid uterus can compress the inferior vena cava and aorta in the supine position, reducing venous return and cardiac output.

Why is "Keep her flat with a head-down tilt" not the answer?

Head-down tilt does not relieve caval compression, and may worsen breathing.

Why is "Place her in the right lateral position" not the answer?

The right side moves the uterus onto the vena cava, because the cava lies on the right.

Why is "Apply a pelvic binder to compress the uterus" not the answer?

A pelvic binder does not treat the supine hypotensive syndrome.

What concept does this question test?

It tests Trauma and burns: positioning of the pregnant trauma patient in General Surgery. Left lateral tilt or manual displacement of the uterus relieves compression, while resuscitation continues. Spinal precautions are kept with a tilted board.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma and burns: positioning of the pregnant trauma patient?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.