A 19-year-old female who is in her third trimester complains of blurred vision and a headache. She tells you the baby is moving, and she denies contractions. Her vital signs are P 84, R 16, BP 152/94, and SpO2 is 97% on room air. You should:

• A. Notify the hospital of a possible stroke.
• B. Check for crowning.
• C. Administer aspirin.
• D. Transport her on her left side.

Answer: (D)

In a pregnant patient in the third trimester presenting with headache, blurred vision, and elevated blood pressure, think preeclampsia with potential progression to seizures. The immediate priority is to optimize maternal-fetal perfusion and arrange urgent transport. Placing her on the left side relieves the aortocaval compression from the uterus, improves venous return to the heart, and increases placental blood flow, which helps stabilize both mother and baby while you get her to definitive care. Crowning check isn’t needed since she reports no contractions, and aspirin isn’t an acute EMS intervention for this scenario. While stroke could be a differential, the safest and most appropriate action now is left-side positioning and rapid transport with continued monitoring.