The womb is a special room for babies from conception to birth. It contains everything your baby needs to survive and develop during pregnancy. Furthermore, it provides support, nourishment, and a place for recreation for your baby.
Inside the womb, babies assume different positions, which can also be referred to as the ‘lie’. This is really important because a baby’s lie may determine the outcome during delivery. Therefore, your doctor or midwife would be really particular about knowing your baby’s lie as you await delivery day.
In this article, you’d discover all you need to know about an important baby position during pregnancy- The Transverse Position.
Who’s A Transverse Baby?
As we mentioned earlier, babies assume different lies or positions in their mother’s womb.
A lie is simply the relationship between the mother’s spine and that of the baby. When the spine of the mother is in the same direction as that of the baby, then the lie is longitudinal. Whereas the attitude of the foremost part of the baby coming out of the birth canal is the baby’s position.
A transverse baby is a baby that lies horizontally in the mother’s womb.
This way, the baby’s spine forms a perpendicular angle to the mother’s spine.
A longitudinal baby has the normal lie. This is because it affords easy passage and delivery through the birth canal. Especially when the baby is presenting with the head, a longitudinal baby can be safely delivered through the vagina without a hitch.
However, the horizontal diameter of the transverse baby is longer than the maternal pelvis. This makes the delivery of a transverse baby almost impossible through the vagina.
What Causes Transverse Baby?
In the early stages of pregnancy, your baby can assume different lies- normal or abnormal. The lie can keep changing at will due to their small size as compared to the size of the womb. This affords them the luxury to kick and turn around. Towards the latter stage of pregnancy and close to delivery, they assume their definitive lie and position.
Only about one in 500 babies will eventually assume a transverse lie at delivery. The rest of the babies will change to the lie which favors delivery. Sadly, experts are still unable to identify the specific cause of the transverse baby position.
However, some of the major risk factors include:
- Pelvic mass: A mass in the pelvis could be a tumor of the cervix, fibroid, or other soft tissue. The presence of a mass will disturb the way the baby lies in the womb. As a result, the baby may assume a transverse lie.
- Polyhydramnios; This is a condition in which there’s excess amniotic fluid in the amniotic sac. The baby bathes and moves around in the amniotic fluid. When there is excess fluid, there is more space for the baby to turn around. So, there is a high chance of a transverse baby.
- Abnormal placenta position: When the placenta occupies the lower part of the womb, it is regarded as placenta previa. It has been shown that placenta previa is frequently associated with the transverse baby positio.
- Multiple pregnancies: They are higher-order pregnancies which could be twins, triplets, or more. The babies in multiple pregnancy have to fit in the mother’s womb. When this happens, one of the babies may have to assume a transverse lie while the other assumes a normal longitudinal lie.
What Are The Effects of a Transverse Baby?
A transverse baby at the time of delivery makes labor difficult.
In most cases, it causes obstructed labor. An obstructed labor occurs when labor comes to a complete halt due to mechanical obstruction. When this happens, it puts the baby at risk of complications such as birth trauma, stillbirth, or distress.
The mother also becomes prone to complications such as uterine rupture, maternal injury, and hemorrhage.
Other complications associated with a transverse baby include;
- Cord prolapse
- Premature birth
- Shoulder dystocia.
To prevent these complications, the recommended mode of delivery of a transverse baby is by a Caesarean section.
How Identify a transverse baby
A transverse baby is easily identified by an ultrasound scan.
An ultrasound scan helps to correctly determine the lie of your baby. It also determines other important parameters as regards the position and presentation of the baby.
During a clinical examination, it can also be determined through a process called the Leopold maneuver.
It involves palpating the uterus through the abdomen. When the head or the buttock of the baby is felt on the right or left side of the mother’s abdomen, it suggests a transverse baby. The doctor may also notice that the length of the womb does not correspond with the month of pregnancy (gestational age).
What Happens Next?
Thankfully, some maneuvers may be performed to change a transverse baby to a normal longitudinal lie. However, it is important to note that these maneuvers do not come with a 100% success rate.
The External Cephalic Version
This is a procedure done after 36 weeks of gestation.
It aims at safely turning the baby from a transverse to a longitudinal lie. It is also used for other reasons such as turning a breech baby into a cephalic baby. An external cephalic version is done by a trained birth doctor or nurse in a hospital with a facility for an emergency Caesarean section. This is because the mother can fall into labor during the procedure.
The ultimate goal of all pregnancies is a safe delivery. A baby that assumes a transverse lie in the mother’s womb at the time of birth poses difficulty during delivery. With a regular antenatal clinic visit, a transverse baby can be easily picked by the doctor or midwife. This allows for adequate preparation for the best means of delivery of the baby.
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Hankins GD, Hammond TL, Snyder RR, Gilstrap LC 3rd. Transverse lie. Am J Perinatol. 1990 Jan;7(1):66-70. doi: 10.1055/s-2007-999449. PMID: 2131781.