UNSTABLE
LIE
PRESENTED BY OKONGWU.C.A
DEFINITION: An unstable lie is when the fetal lie and presentation changes repeatedly after 2 consecutive visits from the 36th week of pregnancy.
INCIDENCE Figures are not available for the incidence of unstable lie in a given population. It’s incidence in a population will be affected by certain factors such as, number of multiparae and particularly number of grand multiparae. Similarly the incidence will be higher in populations where malnutrition is prominent and maternal or fetal skeletal deformities are common
Conversely in well nourished and developed societies where high parity and skeletal deformities are relatively uncommon, the incidence of unstable lie have been quoted to be within the range of 0.1-1.0%.
AETIOLOGY High parity Polyhydramnios Multiple pregnancy Placenta praevia Pelvic tumors Pelvic inlet contracture/or fetal macrosomia Fetal anomaly Uterine anomaly Distended bladder.
RISKS There are no hazards to the mother or the fetus during early pregnancy (up to 28 weeks). During the later weeks of pregnancy spontaneous resolution to a longitudinal lie before onset of labour occurs in about 85% of cases. There are however very serious risks to the mother and the fetus if the lie is not longitudinal at onset of labour. cord prolapse. compound presentation & uterine rupture .
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