Pregnancy is a journey filled with many types of experiences, filled with surprises (both good and bad) along the way. If you are pregnant and the doctor mentions the word “transverse” during the appointment, it means that your baby is positioned sideways instead of the standard “head up” or “head down” situation.
In hindsight, transverse fetal lie is a severe complication for pregnant women that were initially planning a vaginal birth. Since the baby is now in a perpendicular position with the spine, a normal delivery can pose a risk for both the mother and the baby.
Being confused and stressed about the “transverse baby” situation is normal, but we have all the details you need to know in this article.
In this Article
What does the term “Transverse Baby” Mean?
So, when your doctor says, “Your baby is in a transverse position,” what does it mean?
As we mentioned, it means the baby is lying sideways across the stomach instead of in the head down or head up position.
In short, instead of being positioned vertically in the abdomen, the baby is positioned horizontally. The condition is relatively rare during the last trimester and affects as few as 50-500 pregnant women globally.
Despite the rarity, we can’t deny the fact that it happens. So, what are the risks associated with the condition? If the baby is in a transverse position during labor and delivery, vaginal birth imposes a lot of risks and can even cause injury to the baby before they are born.
What Causes a Transverse Baby?
When it comes to exploring the potential causes behind the transverse position presentation during delivery, there are two primary causes worth highlighting:
Bicornuate Uterus – In this condition, the uterus has a V-shaped dip at the top, which divides the uterus into two parts, further contributing to the transverse position of the developing fetus.
Oligohydramnios or polyhydramnios – This is characterized by an exceptionally low or high amount of amniotic fluid surrounding the developing fetus. Either of these conditions requires medical assistance for smooth and safe delivery of the baby and optimal health of the mother.
Besides these two primary causes, a few risk factors that contribute to the presentation of transverse babies in the womb include:
Issues related to the placenta’s positioning, like in the case of placenta previa
- Pre-term labor
- Having twins or multiple babies
- Abnormal pelvic structure of the mother
- Cyst or fibroid that’s blocking the cervix
Besides these complications, experiencing transverse fetal positioning is also common in women during their second or consecutive pregnancies.
How is Transverse Presentation Diagnosed?
Since the condition of a transverse fetal presentation comes with a significant amount of risks, it goes without saying that an early diagnosis and relevant medical interventions are crucial to ensure that both the baby and the mother are safe.
In most cases, the assessment is done during the routine pregnancy check-ups of our patients at Queen’s Gynecology. It can be diagnosed via multiple means, including:
1. Abdominal examination
This involves a physical examination where our OBGYN assesses the fetus’ positioning in the mother’s abdomen. If the baby is transverse, the “presenting” part is the shoulder. If the doctor can’t assess and feel the baby’s bottom and head around the base of the uterus, it is a sign of transverse presentation.
2. Ultrasound
Following Leopold’s Maneuvers to feel the fetal positioning in the abdomen physically, the next step is to conduct an ultrasound examination to confirm the suspicion. If the transverse position is during the earlier weeks of pregnancy, the doctor mostly prioritizes close monitoring to see if the baby changes its presentation in the upcoming weeks.
However, if the baby is still in the transverse position at the 36 weeks check-up, we offer our patients with various options that would be safer for their delivery instead of being reliant on a normal vaginal birth.
When Does the Transverse Presentation Become a Concern?
We have to reiterate that listening to the world’s “transverse presentation” doesn’t have to be so scary. Several babies enter this position during the earlier weeks of pregnancy and gradually shift and move to the ideal head-down or head-up position for delivery.
The situation only becomes a concern when the transverse position is persistent during the last few weeks of pregnancy or right before labor and delivery. If not tended to early, a vaginal birth with the baby in the transverse position can lead to injuries to the fetus and even stillbirth.
Besides risks to the baby, vaginal delivery when the baby is in a transverse position can lead to uterine rupture, which can be fatal for the mother as well.
To avoid such situations, it is crucial to have alternative options for delivery in case vaginal birth isn’t safe at the last minute. Some alternatives in that case include – turning the fetal position or C-section birth.
How to Deliver a Transverse Baby?
If a baby is in a transverse position during labor and delivery, opting for vaginal birth is risky and not recommended at all.
The safest way to deliver a baby when they are in a transverse position is via a C-section. In some cases, if the baby is not yet engaged in the pelvis, we may attempt an External Cephalic Version (ECV). This involves applying pressure on the mother’s abdomen to turn the baby into a head-down position manually.
If attempts to turn the baby are unsuccessful or if the baby is in distress, a cesarean section (C-section) is often performed. This involves surgically delivering the baby through an incision in the mother’s abdomen and uterus.
In some situations involving transverse presentation, a few complications related to the umbilical cord may arise, often posing a medical emergency. Immediate measures need to be taken to avert such risks and to ensure the safety of both the mother and the fetus.
Conclusion
The situation with a transverse presentation can be a little complicated, but with the advancements in the medical field and the expertise of our doctors at Queen’s Gynecology, you are in safe hands. Albeit rare, the condition, when detected early, can be handled with care, and you can rest easy knowing that your labor and delivery experience will be smooth and without a hitch.
In situations such as a transverse lie, our experienced and skilled gynecologists are equipped with the knowledge and expertise to make informed decisions and take prompt, effective action. Your health and the health of your baby are our top priorities. For more details, contact our team at +91 9654999888.
