Transverse lie.
To assess the impact of transverse lie on fetal and neonatal outcome, 14 mother and infant pairs with transverse lie were matched to 28 pairs with a vertex and 28 with a breech presentation. The control groups were matched for gestational age, route of delivery, type of anesthesia, and presence of labor. Infants in transverse lie were found to have a lower absolute arterial pH (7.21 versus 7.27, p less than 0.05) as well as more frequent severe acidosis (pH less than 7.1, 3 of 14 versus 0 of 56, p less than 0.04). Their birthweight was also less (2798 gm versus 3251 gm, p less than 0.05) and they sustained more birth trauma and long-term residual effects than either the breech (5 of 14 versus 1 of 28, p = 0.01) or vertex control groups (5 of 14 versus 2 of 28, p = 0.03). Based on these results, we recommend active intervention at 38 weeks' gestational age, via external version followed by labor induction, or failing this, cesarean delivery.
Hankins
G D
GD
Department of Obstetrics and Gynecology, Wilford Hall, United States Air Force Medical Center, Lackland Air Force Base, TX 78236-5300.
Hammond
T L
TL
Snyder
R R
RR
Gilstrap
L C
LC
D000328:Adult; D001034:Apgar Score; D001720:Birth Injuries / Q000209:etiology; D001946:Breech Presentation; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007746:Labor Presentation; D008297:Male; D007744:Obstetric Labor Complications; D011247:Pregnancy