For Late-Pregnancy Choking, Use Heimlich Maneuver on the Floor


PASADENA, CALIF. — The Heimlich maneuver becomes unwieldy during the late stages of pregnancy, requiring adaptations, Dr. J. Gerald Quirk said at the annual meeting of the Obstetrical and Gynecological Assembly of Southern California.

Breast enlargement, diaphragm displacement, and the size and weight of a pregnant woman all contribute to difficulty in performing the traditional emergency maneuver to prevent choking during late pregnancy.

First described in 1974 by Dr. Henry Heimlich, a thoracic surgeon, the Heimlich maneuver involves standing behind a choking victim and placing a fist, thumb side in, underneath the diaphragm.

Using the other hand to push against the fist, a series of abrupt upward thrusts can usually dislodge a piece of food from the airway.

Not only is it difficult to hold a woman in this position during late pregnancy, it is also hard to exert the force necessary to perform the maneuver correctly, said Dr. Quirk, professor and chair of obstetrics, gynecology, and reproductive medicine at Stony Brook (N.Y.) University.

“The best thing to do is lay her on the floor and press down on the lower part of the sternum,” he said.

The woman should be tilted slightly to one side to prevent aortocaval compression.

Dr. Quirk said several case reports suggest that this adaptation is effective in late pregnancy.

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