• C Wilkinson and M W Enkin.
• Cochrane Db Syst Rev. 2007 Jul 18; 2006 (3): CD000120CD000120.

BackgroundWhen pregnant women near term lie in the supine position the uterus can compress the inferior vena cava, interfering with venous return to the heart. This can result in hypotension, reduced placental perfusion and decreased fetal oxygenation.ObjectivesThe objective of this review was to assess the effects on the fetus or newborn of lateral tilt at caesarean section compared to the operation carried out with the mother in the supine position.Search StrategyWe searched the Cochrane Pregnancy and Childbirth Group trials register.Selection CriteriaRandomised or quasi-randomised trials of lateral tilt (10 to 15 degrees) compared to supine position during caesarean section in pregnant women undergoing elective or emergency caesarean section.Data Collection And AnalysisTrial quality assessment and data extraction were done by one reviewer.Main ResultsThree trials involving 293 women were included. The trials were all methodologically poor. There were fewer low Apgar scores when lateral tilt was used, and pH measurements and oxygen saturation appeared to be better when tilt was used.Authors' ConclusionsThere is not enough evidence from these trials to evaluate use of lateral tilt during caesarean section.

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