Obstetrics Book



Shoulder Presentation

Aka: Shoulder Presentation, Transverse Lie
  1. 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
  2. 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
  3. Epidemiology
    1. Incidence: 0.3% of singleton births
  4. Causes
    1. Prematurity
    2. Placenta Previa
    3. Abnormal Uterus
    4. Contracted Pelvis or relaxed abdominal wall
    5. Polyhydramnios
  5. Diagnosis
    1. Leopold's Maneuvers
      1. Transverse Lie should be easy to identify
    2. Digital cervical exam
      1. No presenting part
  6. 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
  7. Complications
    1. Uterine Rupture

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