This topic contains definition, causes, complications, management and formulation of line of treatment for unstable lie.

1. BY, MS.PRIYANKA GOHIL
M.Sc. (N) OBG
PhD Scholar, MBNC, UTU

2. • This is a condition where the
presentation of the fetus is constantly
changed even beyond 36th week of
pregnancy when it should been
stabilized.

3. • The causes are those which prevent the
presenting part to remain fixed in the
lower pole of the uterus.
• Such conditions are:-
– Grandmultipara with lack of uterine tone
and pendulous abdomen
– Hydromnios
– Contracted pelvis
– Placenta previa
– Pelvic tumor

4. COMPLICATIONS
Cord
Entanglement
Perinatal
Death
Cord
Prolapse

5. ANTENATAL:
• At each antenatal visit, the presentation
and the lie are to be checked.
• If there is no contraindication, external
version is to be done to correct the
malpresentation.

6. :
• The patient has to be admitted at 37th
week
• Premature or early rupture of the
membranes with cord prolapse is the
real danger with the lie remaining
obligue.
• After admission, the investigation is
directed to exclude placenta previa,
contracted pelvis or congenital
malformation of the fetus with the help
of sonography for localization of
placenta

7. • Elective cesarean section (in case of
complication)
• Stabilizing induction of labor:
– External Cephalic version is done after 37
weeks:- oxytocin infusion is started to
initiate effective uterine contraction
– Followed by low rupture of membrane
– Monitoring of labour
– Procedure can be done even after the
spontaneous onset of labour