Causes of Oblique Lie
Several factors can contribute to an oblique lie: Multiparity: Women who have had multiple pregnancies may have weakened uterine muscles, allowing more room for the fetus to assume an oblique position.
Polyhydramnios: Excess amniotic fluid can provide more space for the fetus to move, increasing the likelihood of an oblique lie.
Uterine Abnormalities: Abnormalities such as
fibroids or congenital uterine malformations can affect fetal positioning.
Placental Issues: A low-lying placenta or
placenta previa may obstruct the fetus from assuming a longitudinal lie.
Diagnosis
Diagnosis of an oblique lie is typically made through
abdominal palpation and confirmed via
ultrasound. During a physical examination, the healthcare provider may note the absence of the fetal head or buttocks in the usual locations. Ultrasound can precisely determine the fetal position and identify any potential complications.
Complications
An oblique lie can lead to several complications: Preterm Labor: The abnormal position may irritate the uterus, triggering preterm contractions.
Cord Prolapse: The umbilical cord may slip into the birth canal ahead of the fetus, posing a risk of compression and reduced oxygen supply.
Obstructed Labor: The misalignment can make it difficult for the fetus to pass through the birth canal, necessitating
cesarean delivery.
Management
Management of an oblique lie depends on the gestational age and the presence of any associated complications: Observation: If detected early in the pregnancy, the position may spontaneously correct itself. Regular monitoring through ultrasound is recommended.
External Cephalic Version (ECV): Around 37 weeks of gestation, an ECV may be attempted to turn the fetus to a cephalic position. This procedure has its risks and is not always successful.
Cesarean Delivery: If the oblique lie persists or if complications arise, a cesarean section may be the safest delivery method.
Prognosis
The prognosis for an oblique lie largely depends on timely diagnosis and appropriate management. With vigilant monitoring and intervention, most pregnancies can result in healthy outcomes for both the mother and the fetus.
