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What’s the transverse lie?

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Transverse lying is when a baby is sideways in the uterus before delivery, making vaginal delivery difficult. Options to move the baby include exercises and manipulation, but a C-section may be necessary. Routine prenatal care is important to identify risks.

Transverse lying is a situation where a baby lies sideways in the uterus before delivery. It is usually not possible to deliver vaginally when a baby is in this position, because while the cervix and vagina are elastic and able to expand, they are not elastic enough to accommodate a laterally exiting baby. When it becomes apparent that a baby is in this position, there are a few options that can be pursued to see if the baby can be moved before the mother goes into labour. If the baby remains still, a cesarean section is usually recommended for delivery.

In early pregnancy, the fetus changes its position a lot, as many expectant mothers have noticed. At various stages, the fetus may lie sideways. As the fetus develops and gets larger, however, it tends to assume an upright position because the shape of the uterus causes the fetus to be upside down or right-side up. The upside down position is ideal, to deliver the baby upside down. If the baby is upright, with the feet pointing down, it is said to be in the breech position.

An ultrasound exam in the latter stages of pregnancy will determine where the baby is and whether action needs to be taken to move the baby or change the birth plan. Sometimes a shift from the transverse lying to a safer position for birth can be encouraged. Expectant mothers can use various exercises and the baby can be manipulated from the outside by a qualified healthcare professional. If the baby moves into the correct position and stays there, the delivery can proceed as planned. If not, it might be time to discuss a C-section. Working with the child in this position is usually not recommended.

Some people are at a higher risk of developing a cross-cutting lie. Women who have had multiple pregnancies, women expecting twins or higher order multiples, women with unusual uterine shapes, or women with growths that block the fetus may be more likely to experience a cross lie. A move to a position unsafe for delivery cannot be prevented, but if it is identified early enough, it may be possible to move the baby.

The risk that a baby could end up in a breech or cross lie is a very important reason to receive routine prenatal care. If these risks are not identified before labor begins, they can endanger the mother and baby.

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