38 weeks primi in early labour with transverse presentation. TOC is
Ans. is c i.e. LSCS When a patient with transverse lie is seen in labour, it is managed as follows according to Dutta Obs. 6/e, p 397. Early labor ECV - provided there is good amount of liquor amnii and there is no contraindication. ECV should be tried in all cases. LSCS - is the preferred method of delivery if version fails or is contraindicated. ate labor Baby alive - If the baby is mature and fetal condition is good, it is preferable to do LSCS in all cases. Baby dead - LSCS even in such cases, is much safer in the hands of those who are not conversant with destructive operation. If the obstetrician is conversant with destructive operation, decapitation or evisceration is to be done. Following destructive operation, the uterine cavity is to be explored to exclude rupture of uterus. Internal version should not be done. According to Onset of active labor in a woman with a transverse lie is an indication for cesarean delivery. Once labor is well established, attempts at conversion to a longitudnal lie by abdominal manipulation are likely to be unsuccessful. Before labor or early in labor, with the membranes intact, attempts at external version are woh trying in absence of other complications that indicate cesarean section. In the given question 38 weeks primi is presenting in Early labour so external cephalic version could have been tried. but it is not given in the option, so our answer is LSCS. Note : While doing LSCS--a transverse incision into the uterus may lead to difficult fetal extraction. Therefore a veical incision is typically indicated.
Allow for cervical dilatation
Internal podalic version
LSCS
Forceps