Evaluation of Transverse Lie at Term by Ultrasonography
AbstractContext: Transverse lie at term may have adverse consequences on both the mother and the foetus.
Evaluating transverse lie at term by ultrasonography may reduce these adverse consequences and
improve both the maternal and fetal outcome.
Objectives: To determine predisposing factors to persistent transverse lie at term using abdominal
ultrasonography and the outcome of such pregnancies.
Study- Design, Setting and Subjects: This was a cross-sectional study of pregnant women at term with
persistent transverse lie referred to the Ultrasound Unit of the Federal Medical Centre, Lokoja, Nigeria.
Results: Out of a total of 1296 scanned during the evaluation period, 42 (3.2%) had transverse lie at
term. Five (11.9%) patients were primigravida and 37 (88.1%) multipara. No predisposing factors were
seen on ultrasound in 25 women (59.5%). Placenta praevia was diagnosed in 11 (26.2%), lower segment
fibroid in 5 (11.9%) and pelvic kidney in 1 (2.4%). Thirty nine patients (92.1%) were delivered by
caesarean section (CS). Three (7.1%) spontaneously converted to longitudinal lie [1 Breech and 2
Cephalic]. All 3 were delivered per vaginam. There were no maternal deaths but there were 2 stillbirths.
Conclusion: Majority of the patients had no predisposing factor seen on ultrasound and were largely
multiparous women. Placenta praevia was the commonest predisposing factor found at
ultrasonography. Caesarean section rate was very high, largely due to the fact that external cephalic
version (ECV), which has been advocated as an alternative mode of delivery of infants lying transversely
at term, is not currently practised in our centre.
Key Words: Transverse Lie, Malpresentation, Ultrasound, Caesarean Section
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