title: Lateral tilt for caesarean section.
abstract: BACKGROUND
  When 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.
  
  
  OBJECTIVE
  The 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.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group trials register.
  
  
  METHODS
  Randomised 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.
  
  
  METHODS
  Trial quality assessment and data extraction were done by one reviewer.
  
  
  RESULTS
  Three 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.
  
  
  CONCLUSIONS
  There is not enough evidence from these trials to evaluate use of lateral tilt during caesarean section.
authors.affiliation: Department of Perinatal Medicine/University Department of Obstetrics & Gynaecology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia, 5006. cwilkins@medicine.adelaide.edu.au
authors.forename: C
authors.initials: C
authors.lastname: Wilkinson
authors.forename: M W
authors.initials: MW
authors.lastname: Enkin
mesh_terms: D002585:Cesarean Section; D005260:Female; D006801:Humans; D011187:Posture; D011247:Pregnancy