Objective: Left uterine displacement with right lumbar wedge has been used to decrease incidence and severity of maternal hypotension and to improve neonatal outcome. However, a recent systematic review shows no clear evidence of benefit. The aim of the study was to evaluate the role of using a right lumbar wedge after spinal anesthesia in the incidence of perioperative maternal hypotension during cesarean delivery.
Material and Method: Two hundred healthy women undergoing elective cesarean section were randomly allocated immediately after spinal block to either a 15 degree of right lumbar-pelvic wedge position (Wedge group, n = 100) or supine position (Supine group, n = 100). Hemodynamic values, vasopressor requirements, neonatal APGAR score and umbilical blood pH were collected.
Results: The incidences of hypotension were similar (81.63% in Wedge group vs. 79.17% in Supine group, p = 0.856). There were no differences in the lowest systolic and mean blood pressure, intraoperative fluid, vasopressor requirements, neonatal APGAR score and umbilical blood pH.
Conclusion: The use of a fifteen-degree right lumbar-pelvic wedge, when compared to complete supine position, was not effective in reducing the incidence of hypotension in spinal anesthesia for cesarean delivery.

Keywords: Left uterine displacement, Right lumbar wedge, Cesarean section, Spinal anesthesia, Hypotension