35 years old primipara in labour with transverse lie. Treatment of choice is -
Ans. is 'b' emergency caesarean section (Ref. Dutta, 6/e, p 397 (5/e, p 426 and p406)).Patients in labour with transverse lie are usually managed by external cephalic version followed by surgical rupture of the membrane.But the lady is an elderly primi so external cephalic version is contraindicated in her.This patient requires an emergency caesarean section.Contraindications of versionSevere preeclampsia or marked hypertensionPost caesarean pregnancyPlacenta previaSevere degree of contracted pelvisFetal malformationsElderly primigravidaeMultiple pregnancy.
Internal cephalic version
Emergency cesarean section
Wait and watch
External cephalic version