UNCONTROLLED WHEN PRINTED
Indications
  • In the pregnant patient, supine positioning can result in aortocaval compression. The gravid uterus can compress the inferior vena cava and aorta resulting in reduced cardiac output and hypotension.
  • Manually displace the uterus to the left  of pregnant patients in cardiac arrest to relieve aortocaval compression
Contraindications
Contraindications
Patient Factors & Considerations
  • Do not apply downward pressure as this will increase aortocaval compression.
  • Evidence supports the use Manual Uterine Displacement over Left Lateral Tilt (LLT) as LLT hinders the ability to perform high-quality chest compressions.
Procedure
  • Pregnant patient in cardiac arrest should receive high quality CPR with Manual Uterine Displacement (MUD) to relieve aortocaval compression.
  • Relief of aortocaval compression must be maintained continuously during resuscitative efforts and continued if ROSC is achieved.

From the patients left side

  • Using a two handed technique, cup and lift the uterus leftwards and upwards off the main vessel (Figure B)

From the patients right side

  • Using a 1 handed technique to push the uterus upwards and leftwards off the maternal vessels (Figure A)
MUD1
Success
Success
Discontinue
Discontinue
Additional Information

References

Images sourced from American Heart Association 2017


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