Transverse lie

Definition

Lie

• In a transverse lie the fetal long axis lies across the long axis of the uterus.
• It is favoured by multiparity, polyhydramnios, placenta praevia.

• Lie describes the relationship of the fetal long axis or spine to the long axis of the uterus and mother; the normal lie is longitudinal.
• In transverse lie the fetal long axis is perpendicular or oblique rather than parallel to the maternal long axis; together with oblique lie it belongs to the non-longitudinal lies.

Aetiopathogenesis

Aetiology and risk factors

• Abnormal lie occurs, among other things, with fetopelvic disproportion, fetal anomalies, structural uterine changes such as fibroids or synechiae and multiple pregnancy.

Clinical features

Dangers

• With rupture of the membranes there is a risk of a cord or arm prolapse.
• Neglected transverse lie arises when contractions in transverse lie lead to rupture.
• The Bandl ring is then a warning sign of impending rupture.

• Transverse lie is often accompanied by shoulder presentation, in which the fetal shoulder is closest to the pelvic inlet; vaginal birth is then not possible.

Diagnosis

• Ultrasound is used in addition and to confirm the diagnosis whenever an abnormal lie or presentation is suspected.

Keep learning in the app

Further reading (selection)

1. MSD Manual Professional Edition: Fetal Presentation, Position, and Lie (Including Breech Presentation)
2. StatPearls: Leopold Maneuvers (NCBI Bookshelf)
3. DocCheck Flexikon, Querlage

Cross-references