Which maternal position during the third trimester is most likely to cause compression of the inferior vena cava, leading to maternal dizziness and reduced uteroplacental blood flow?
Supine (lying flat on the back)
Right side-lying (right lateral decubitus)
Semi-Fowler (sitting upright at about 45°)
Left side-lying (left lateral decubitus)
The supine (flat-on-back) position allows the weight of the enlarged uterus to compress the inferior vena cava and, to a lesser extent, the abdominal aorta. This reduces venous return to the heart, lowers cardiac output, and decreases blood flow to the placenta. Clinical manifestations include dizziness, pallor, hypotension, and fetal heart-rate decelerations. Placing the client in a lateral side-lying position (preferably left lateral) or having her sit upright relieves the compression and restores circulation. The right- or left-side-lying positions and the semi-Fowler (45° upright) position do not typically cause the same degree of aortocaval compression and are preferred for maternal comfort and fetal oxygenation.
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