An instrument to relieve inferior vena cava occlusion

Abstract

THE. RELIEF Of inferior vena cava occlusion by left uterine displacement, the most valuable method to correct maternal hypotension prior to vaginal delivery under spinal anesthesia,1 awaits full utilization in cesarean section. Although left uterine displacement is produced easily, maintaining the displacement during cesarean section is difficult because the anesthesiologist does not have access to the right side of the patient. This space is occupied by the surgical assistant or occasionally by the surgeon, neither of whom for more than a moment can exclude a hand from the operation to hold the uterus to the side. This report describes and evaluates an instrument to maintain continuous left uterine displacement prior to delivery without interfering with the performance of cesarean section. The instrument,* made of stainless steel, is shown in Fig. 1. The angular mounting of the horizontal piece provided by the slot and groove arrangement eliminates interference with the person working from the right side of the table. Also, contact with the thigh when the legs are in stirrups is avoided if used during vaginal delivery. The body contact bar is placed just above and between the rib margin and iliac crest (Fig. 2). Because of uterine mobility, displacement is easily produced and the instrument merely maintains displacement. Continuous left uterine displacement main-