Transverse lie in labor: A study from Kaduna, Northern Nigeria

Abstract

Context: Transverse lie of the fetus in labor is an emergency that could be potentially live threatening and clinically tasking to the Obstetrician.
Objective: To determine the incidence and clinical outcome in transverse lie.
Study design, setting, and subjects: A-12 ½ year retrospective study of all women who presented with fetuses in the transverse lie during labor at a tertiary institution.
Results: During the period there were 16633 deliveries and 30 women with transversely lying fetuses, giving an incidence of 1 in 554 deliveries. Forty percent of the cases were neglected transverse lies. The para 4 and above group had the highest incidence of 2.69/1000. Northern minorities ethnic group had the highest incidence of 2.35% and the Ibos the lowest incidence of 0.48/1000. The highest incidence of transverse lie was among women that were not registered for prenatal care, 3.89/1000 as against those registered, 1.46/1000. Eighty percent of the women were delivered abdominally; and 63.33% of these were cesarean deliveries. Vaginal
delivery was achieved in 13.33% of the women, vaginal route destructive operations and delivery in conduplicatio corpore on two occasions each. Anencephaly was the only gross congenital malformation seen among the infants. Sixteen perinatal and six maternal deaths were recorded. Two women died undelivered. Transverse lie was associated with uterine fibroids, abdominal pregnancy, second twin with ruptured membranes and
pendulous abdomen.

Conclusion: Transverse lie in labor is associated with high perinatal and maternal mortality.

Keywords: Transverse lie incidence delivery outcome