Obstetric anesthesia: aortocaval compression: practice question

A Anaesthesia 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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Anaesthesia · Obstetric anesthesia: aortocaval compression

Sample item

At term, a supine pregnant patient becomes pale and hypotensive during preparation for cesarean delivery. What positioning maneuver is most appropriate?

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

The answer and the reasoning

B. Left uterine displacement

The gravid uterus can compress the inferior vena cava and aorta in the supine position, decreasing venous return and uteroplacental perfusion. Left uterine displacement reduces this aortocaval compression.

Option by option

  • A. Sitting fully upright without support

    Upright positioning alone does not specifically provide reliable uterine displacement during operative preparation.

  • B. Left uterine displacement (correct)

    Correct. Moving the uterus leftward relieves compression of major vessels.

  • C. Trendelenburg with right tilt

    Right tilt may worsen aortocaval compression.

  • D. Prone positioning

    Prone positioning is generally impractical in this setting.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Left uterine displacement. The gravid uterus can compress the inferior vena cava and aorta in the supine position, decreasing venous return and uteroplacental perfusion.

Why is "Sitting fully upright without support" not the answer?

Upright positioning alone does not specifically provide reliable uterine displacement during operative preparation.

Why is "Trendelenburg with right tilt" not the answer?

Right tilt may worsen aortocaval compression.

Why is "Prone positioning" not the answer?

Prone positioning is generally impractical in this setting.

What concept does this question test?

It tests Obstetric anesthesia: aortocaval compression in Anaesthesia. Left uterine displacement reduces this aortocaval compression.

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 Obstetric anesthesia: aortocaval compression?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.