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Shoulder Presentation

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Shoulder Presentation, Transverse Lie

  • See Also
  1. Fetal Malpresentation
  2. Fetal Presentation
  3. Fetal Lie
  4. Fetal Position
  5. Twin Gestation
  6. Occiput Posterior
  7. Breech Presentation
  8. Face Presentation
  9. Brow Presentation
  • Definitions
  1. Transverse Lie
    1. Fetal Lie perpendicular to mother's long axis
  2. Shoulder Presentation
    1. Occurs when fetus is transverse with back down
    2. Shoulder sits over pelvic inlet
  • Epidemiology
  1. Incidence: 0.3% of singleton births
  • Causes
  1. Prematurity
  2. Placenta Previa
  3. Abnormal Uterus
  4. Contracted Pelvis or relaxed abdominal wall
  5. Polyhydramnios
  • Diagnosis
  1. Leopold's Maneuvers
    1. Transverse Lie should be easy to identify
  2. Digital cervical exam
    1. No presenting part
  • Management
  1. Ceserean section required in most cases
  2. Indications to consider External Cephalic Version
    1. Intact membranes and no labor
    2. Back-up Transverse Lie with Cervix fully dilated
  • Complications
  1. Uterine Rupture