Unstable Lie

• usually multiparous patient

Causes

• lax abdominal and uterine muscles

• polyhydramnios

• distortion of lower uterine pole

  • placenta

  • tumour

• abnormal foetus

amniotic fluid greatest at 35 week and reduced at term. increasing foetal size reduces relative space and may stabilise lie

Management

• Conservative

• External version to longitudinal lie in theatre (prepared for Caesarean section) with immediate rupture of membranes

  • risk cord prolapse

• Elective Caesarean section

• Termination of an abnormal foetus

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