11 - Obs - Abnormal Lie and Breech Presentation - Abnormal (transverse and oblique) lie

Question 1

Lie: r’ship of fetus to ? axis of uterus. Presentation: Cephalic or ? – either is palpable at pelvic ?. If neither – ? or ? lie. Abnormal lie: 1/??? births, more common in ? preg – normalizes at ?

Answer 1

long
breech
inlet
transverse or oblique
200
earlier
term

Question 2

Aetiology
? labour more commonly compx by abnormal lie than ?
term.
Circumstances allowing more room to turn eg ? or ? parity are most common causes -> ?/freq changing lie.
Conditions preventing turning eg fetal or uterine abnormalities and ? can also be a cause.
Conditions preventing engagement eg ?? and pelvic ? or ? deformity also. Unstable lie in nulliparous = ?.

Answer 2

preterm
full
polyhydramnios
high
unstable
twins
PP
tumours
uterine
rare

Question 3

Complications
If ?/head cant enter pelvis, ?cannot deliver fetus. An arm/cord may ? when membranes rupture and ? can eventually -> uterine ?. Fetus and mother at risk.

Answer 3

breech
labour
prolapse
obstruction
rupture

Question 4

MGMT
No action before ?wks unless woman in ?. After ?wks woman admitted to hosp in case ? ?, ??? to r/o identifiable causes eg ? and ??. ECV not used as fetus turns ?. If spont version occurs and persists >?hrs, can ?. If no pelvic ?, abnormal lie usually corrects by ?wks. If woman is in labour, persistently abnormal lie is delivered by ??, but ??? then ? can be done.

Answer 4

37
labour
37
membranes rupture
USS
polyhydramnios 
PP
back
48
discharge
obstruction
41
C/s
ECV 
amniotomy (AROM)