During CPR for a patient over 20 weeks gestation, which step helps reduce pressure from the uterus on the inferior vena cava?

• A. Begin defibrillation immediately
• B. Elevate the legs
• C. Administer nitroglycerin
• D. Manually displace the uterus to the left

Answer: (D)

Late in pregnancy, lying flat can cause the uterus to press on the inferior vena cava, reducing venous return to the heart and making CPR less effective. Manually displacing the uterus to the left relieves that pressure, improves preload, and helps chest compressions work better. The other actions don’t address the mechanical compression: defibrillation targets rhythm, nitroglycerin isn’t used during CPR, and elevating the legs helps venous return only indirectly without removing the uterine compression.