Transverse lie

It is not uncommon for the foetus to have a transverse lie until about the 32nd week of pregnancy. However if the foetus continues to adopt a transverse lie after this period then a possible cause should be determined. A transverse lie may occur in association with the following conditions:

• grand multiparity
• polyhydramnios
• prematurity
• subseptate uterus
• pelvic tumours such as fibroids, ovarian cysts
• placenta praevia
• multiple pregnancy
• foetal abnormality

The main dangers of a transverse lie is the associations with pre-term rupture of membranes and cord prolapse.

The persistence of transverse lie in labour is an indication for caesarian section.

Notes:

• the causes and management of an oblique lie are similar to those for a transverse lie
• in a transverse lie there is an anatomical relationship in which the long axis of the fetus lies at right angles to the long axis of the mother
  • i.e. the longitudinal axis of the fetus straddles across the horizontal axis of the uterus
• in an oblique lie there is an anatomical relationship in which the fetal axis crosses the maternal axis at an angle other than a right angle
  • i.e. no fetal presenting part is palpable in the lower pole and the head or the breech is in an iliac fossa