A woman who goes into labor in an oblique position is in danger of delivering her baby in an expedited C-section. Ideally, the baby’s head should be in the pelvic area as contractions begin. However, this can be difficult to achieve if the position is not ideal.
Transverse lie
During pregnancy, the fetus is in a state of lying on its back or in a transverse position. This presentation is the most common type of presentation. It is, also referred to as a breech presentation. In transverse lie, a baby presents with a back or breech presentation. The baby may also present with small parts such as the umbilical cord. It may be in a breech or cephalic position. It can be temporary, or a fetus may convert from a transverse position to an oblique position.
Obstetric complications associated with transverse lie include prolapse of the umbilical cord, intrauterine infection, and maldevelopment due to oligohydramnios. However, these complications can be avoided or managed. Transverse lie can be corrected by rotating the baby before delivery, but the obstetrician may opt for C-section if the rotation is unsuccessful. If the transverse presentation is, not corrected, it can lead to obstetrical complications and birth injuries.
The most common transverse lie presentation occurs in the 20 to 30 week gestational age range. However, the rate of transverse lies increases as the fetus approaches term. During the early part of pregnancy, only about one in every 300 fetuses is in the transverse position at delivery.
Transverse lie is more common than oblique position, but one in every three transverse babies remains in this position until delivery. The care for transverse babies is the same as for obliquely-positioned babies. During the final trimester, at 36 weeks, midwives will check the position of your baby. If they cannot feel the bottom or head of the baby in the pelvis, they may suspect that the baby is transverse and perform an ultrasound to confirm this.
In a recent study, researchers at the University of Kentucky Medical Center observed 235 women with transverse lie at the time of their delivery. They found that transverse lie was more common at early gestational age and had increased incidence with subsequent breech presentation. In addition, the rate of transverse lie decreased dramatically during the third trimester, while transverse lie was more common in the first trimester. The study showed that transverse lie was, associated with low placenta implantation and other potentially predisposing anatomic factors.
Premature fetuses are smaller than term fetuses, and have less control of their muscles and neurologic system. This results in deflexion of the fetal head, which compromises delivery. These problems are more common in preterm labor but can still occur during full-term pregnancy.
