Fetus in transverse position. Which of the following is true:
Correct Answer: Polyhydramnios is a cause
Description: Ans- (A) Polyhydramnios is a causeRef. William's Obstetrics 23rd ed. Ch 20, Abnormal Labor* For this question, most of the students usually go for <D> shoulder dystocia is a threat for this condition. But remember one thing that shoulder dystocia usually results in the longitudinal lie, where the head of the baby is born and rest of the body below the neck is stuck, which can be secondary to the contracted pelvis, macrosomic baby etc.* This is a clear case of a transverse lie.TRANSVERSE LIE* Transverse lie is seen in 0.3% of the cases.* In this position, the long axis of the fetus is approximately perpendicular to that of the mother.* In a transverse lie, the shoulder is usually positioned over the pelvic inlet. The head occupies one iliac fossa, and the breach the other (as seen in question).* This creates a shoulder presentation in which the side of the mother on which the acromion rests determines the designation of the lie as of right or left acromial.Etiology* Women with four or more deliveries have a 10-fold incidence of transverse lie compared with nulliparas.* Common causes of transverse lie include:# Abdominal wall relaxation from high parity# Preterm fetus# Placenta previa (NOT abruption placentae)# Abnormal uterine anatomy# Hydramnios, and# Contracted pelvis.Diagnosis* A transverse lie is usually recognized easily, often by inspection alone.* The abdomen is unusually wide, whereas the uterine fundus extends to only slightly above the umbilicusManagement: Active labor in a woman with a transverse lie is usually an indication for cesarean delivery.
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