Question: In what position should the patient be placed after the spinal injection?

Answer: Immediately after the spinal injection, the patient should be placed on her back and tilted 15° to the left hand side either by using the operating table or by inserting a pillow or wedge under the right buttock (Fig 1). This should tilt the pelvis to around 15°.

The blood pressure and heart rate must be checked every 2-3 minutes. Ask the mother to tell you if she starts to feel faint or sick.

Question: Why must the mother be tilted 15° and the blood pressure frequently checked?

Answer

Question: In what position should the patient be placed after the spinal injection?

Answer: Immediately after the spinal injection, the patient should be placed on her back and tilted 15° to the left hand side either by using the operating table or by inserting a pillow or wedge under the right buttock (Fig 1). This should tilt the pelvis to around 15°.

The blood pressure and heart rate must be checked every 2-3 minutes. Ask the mother to tell you if she starts to feel faint or sick.

Question: Why must the mother be tilted 15° and the blood pressure frequently checked?

Answer: The tilt is to reduce aorto-caval compression (the effect of baby compressing the mother’s inferior vena cava and aorta). This causes a decrease in venous return to the heart and a fall in cardiac output and blood pressure (Fig 2). Select play to watch the animation.

Check the blood pressure regularly as the spinal commonly causes a drop in blood pressure causing symptoms of nausea or sickness in the mother. If the blood pressure is not treated and returned to normal levels, it may compromise the mother or baby.