1.

Define transverse lie

Tranverse lie is a condition where the axis of the fetus is across
the axis of the uterus.It is common before term,but only 1%
after 37 weeks.

3.what is the expectant management in transverse lie?

In patient management is suggested at 37 weeks.Daily assessment
is done and mother is to be discharged once lies has stabilized
longitudinally for 48 hours.Spontaneous version to longitudinal
lie occur in 80-85% prior to labour or membrane rupture.

5.Mention two complication of malpresentation.

Obstructed labour
Uterine rupture
Risks of cord prolapse
Asphyxia to the baby

7.A multigravidae at 39 weeks came in with prelabour rupture

of membranes. On palpation the fetus is in transverse lie. What
is the most appropriate management?
Emergency LSCS.Cannot do ECV because ruptured membrane is
the contraindication of ECV.

9. Mention the predisposing factors of cord prolapse.

-Abnormal lie
-multiple pregnancy
-breech presentation
-acute polyhydramnios
-prematurity
-high head
-long umbilical cord
-interventional cause-ECV,IPV of second twin,ARM with an
unengaged presenting part,fetal scalp electrodes,stabilizing
induction of labour.
11. How can you prevent cord prolapse?
-women with transverse,oblique or unstable lie should be offered
elective admission at hospital at 37+6 weeks of gestation.

- Women with noncephalic presentations and preterm prelabour

rupture of the membranes should be offered admission.

-Bradycardia or variable fetal heart rate decelerations have been

associated with cord prolapse and their presence should prompt
vaginal examination.
- Artificial rupture of membranes should be avoided whenever
possible if the presenting part is unengaged and mobile.

13. What are the immediate mamangement steps of cord

prolapse?
1-Assistance should be immediately called ,
2-Venous access should be obtained,
3-Consent taken and
4-Preparations made for immediate delivery in theatre.
5-Prevent spasm by preventing exposure of the cord-reduce the
cord into the vagina to maintain body temperature and cover with
surgical packs soaked in warm saline.
6-To prevent further cord compression-Fill the bladder with 500
ml of warm normal saline to displace the presenting part upwards.
-A hand in the vagina to push the
presenting part upwards.
-Knee chest position.

15. Mention two complications of cord prolapse.

Asphyxia to the baby may results in cerebral palsy and hypoxic
ischaemic encephalopathy.