A 37-year-old female is 36 weeks pregnant. She tells you that she has a severe headache and blurred vision. She describes decreased fetal activity today. Her vital signs are P 86, R 14, BP 138/90, and SpO2 is 96% on room air. You should transport her:

• A. With her hips elevated.
• B. In the knee-chest position.
• C. Supine.
• D. On her left side.

Answer: (D)

When a woman is in the late third trimester with signs that could be preeclampsia, the priority during transport is to maximize placental perfusion and maternal venous return. Lying on the back can cause the gravid uterus to compress the inferior vena cava, reducing venous return to the heart and decreasing uteroplacental blood flow. Placing her on the left side relieves this compression, improves preload and cardiac output, and increases blood flow to the uterus and placenta, helping both mother and fetus during transport. The headaches and blurred vision indicate possible end-organ involvement, so optimizing perfusion is essential. Supine positioning would worsen vena cava compression; knee-chest is not indicated for this presentation; elevating the hips alone won’t adequately relieve the compression. So, transport with the patient in the left lateral position.