Transverse fetal lie
- Robert A Strauss, MD
Robert A Strauss, MD
- Professor of Obstetrics and Gynecology
- University of North Carolina at Chapel Hill
Transverse lie refers to a fetal presentation in which the fetal longitudinal axis lies perpendicular to the long axis of the uterus. It can occur in either of two configurations:
●The curvature of the fetal spine is oriented upward (also called "back-up" or dorsosuperior), and the fetal small parts and umbilical cord present at the cervix.
●The curvature of the fetal spine is oriented downward (also called "back-down" or dorsoinferior), and the fetal shoulder presents at the cervix (figure 1).
(Note: Lie refers to the long axis of the fetus relative to the longitudinal axis of the uterus; it can be longitudinal, transverse, or oblique. Presentation refers to the fetal part that directly overlies the pelvic inlet; it is usually vertex [head] or breech [buttocks], but can be a shoulder, compound [eg, head and hand], or funic [umbilical cord]. Position is the relationship of a nominated site of the presenting part to a denominating location on the maternal pelvis, eg, right occiput anterior.)
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- NATURAL HISTORY
- PATHOGENESIS AND RISK FACTORS
- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- MANAGEMENT OF DELIVERY
- Transverse lie, intact membranes, live fetus
- - Before onset of labor
- - Early labor
- - Active labor
- Transverse lie with ruptured membranes
- Transverse lie of second twin after delivery of first twin
- Transverse lie with fetal demise or previable fetus
- Transverse lie with coexistent placenta previa or umbilical cord prolapse
- PROCEDURE FOR CESAREAN DELIVERY
- Dorsosuperior (back up) transverse lie
- Dorsoinferior (back down) transverse lie
- SUMMARY AND RECOMMENDATIONS