When performing CPR on a pregnant patient, what modification is recommended?

• A. Place on left side and compress slightly higher on the sternum
• B. Place on back with standard compressions
• C. No changes to CPR technique
• D. Place on right side and reduce depth

Answer: (A)

When a pregnant patient, especially in the later stages, is lying flat the gravid uterus can compress the aorta and inferior vena cava, reducing venous return and hindering effective CPR. To counter this, tilt the patient to the left side to move the uterus off those vessels and improve preload. Because the heart sits higher in the chest during pregnancy due to diaphragm elevation, you should place your hands slightly higher on the sternum to ensure the heart is being compressed properly with chest compressions. Use standard compression depth and rate, and reassess positioning as needed to maintain effective circulation. The other options would fail to relieve aortocaval compression or fail to target the heart effectively in this physiological scenario.