Transverse presentation is when a baby lies sideways in the uterus, making vaginal delivery impossible. It can be caused by premature birth, placenta previa, or other factors. Doctors may attempt to turn the baby, but a C-section is usually necessary. Complications include musculoskeletal issues and oxygen deprivation. Access to medical care is crucial for a safe delivery.
Transverse presentation or transverse lying describes a baby’s position in the uterus when it lies sideways, horizontally across the uterus. This is opposed to the head-down position that many babies assume a few weeks before birth or the more complicated head-down position of a breech-positioned baby. In both cases, the baby is upright and a vaginal delivery is an option. A fetus could be in any of these positions, including transverse presentation, for months before the end of pregnancy, but by the time of birth, transverse lying usually requires a C-section. Vaginal birth is generally thought to be unacceptable or possible unless the fetus can be transformed.
There are many potential reasons why a cross presentation can occur, although it is not a very common occurrence. A premature birth can sometimes result in this presentation because the baby simply hasn’t had enough time to move into the head-down position. Placenta previa, where the placenta is low in the uterus, can alter the positioning of the baby and is more likely to cause transverse lying. Sometimes a malformation of the uterus or any type of unusual dividing wall can limit movement and inhibit rotation of the fetus.
A multiple pregnancy is sometimes associated with a higher risk of transverse presentation of multiple second-order or higher babies. Large amounts of amniotic fluid increase the risk of this condition. Having weakened abdominal muscles can also make it easier for a fetus to come in a transverse position.
The positioning of the baby or babies in the late pregnancy is noted carefully during the prenatal exams. If a pregnancy is nearing its end and a baby is in transverse presentation, doctors may attempt to turn the baby, unless there is a clear indication that it won’t work. When preterm or regular labor occurs spontaneously, attempts may be made in the early part of labor to transform the baby as well, but if these attempts are unsuccessful, cesarean delivery is very important.
There is a risk to the baby’s musculoskeletal system due to the transverse presentation, and in many cases, the baby simply cannot enter the birth canal all the way if it is vertical. Additional risks include complications such as prolapse of the umbilical cord and deprivation of oxygen to the fetus long before birth occurs. With access to a qualified medical facility, these complications of a cross-lie presentation can be avoided, and most full-term babies in this location are delivered healthy via C-section. Where there is no access to medical care, the situation is dangerous, especially for the fetus. A suspected cross-sectional presentation is best treated with sophisticated medical intervention to provide better outcomes for mother and baby.
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