Any experience of unstable transverse lie?

[graysor]

I went in to maternity triage on Saturday morning with some concerns about reduced movements. I’m 38 weeks.

While monitoring baby moved from his previous head down position to transverse lie. So they admitted me to the antenatal ward, because of the risk of cord prolapse if my waters break while baby is transverse.

Baby seems fine, but possibly with too much fluid around him, enabling him to move between head down and transverse.

I’m completely in limbo until they do a scan on Monday (couldn’t be done at the weekend apparently). But I also can’t get any sensible info out of the midwife or doctor about what will happen after the scan.

Does anyone have any experience of a similar situation?

If baby is still transverse and unstable when they scan what will happen then?

I really just want to go home and see my dd, but I’m worried they’ll keep me in after the scan, and no one will tell me for how long it could be for, or what the next steps will be.

Feeling sad and sorry for myself sat on the antenatal ward, so any nuggets of info would be appreciated!

My son was unstable lie/ transverse at 37 weeks, it was picked up at a position scan, they admitted me due to the risks. Had my waters broken, a cord prolapse gives them minutes to perform a CS.

I was told that baby would need to turn (either breech or cephallic) and remain there for 48 hours before they would be happy to discharge me, if he remained transverse or didn't turn breech or cephallic I would remain in hospital until 39 weeks when they would perform a CS.

He did turn on his own, back to breech which had been his main position throughout the pregnancy and I was booked for an elective CS at 39 weeks - he turned cephallic the night before the CS but didn't engage. We only discovered this on the morning the morning I was booked for the CS, I was offered an option for induction instead (for various reasons they has wanted him out at 39 weeks) but declined as he wasn't engaged, so in all likelihood it would have led to a failed induction and EMCS.

My boy was unstable lie. I'd had a scan following reduced movements to be told that he was transverse after previously being head down. I was admitted, and he moved back head down, so they attempted to induce. We repeatedly asked them to check that he had stayed head down as. I was concerned he had moved again and they kept saying it would be fine.

It wasn't fine. They only discovered this after attempting to induce me twice. We were waiting to be taken to the labour ward to have my waters broken when they did routine monitoring and found that he was again transverse. They then called a consultant who scanned me and said that my waters were about to burst and due to the positioning of baby, the cord was low down and if my waters broke, it would be guaranteed to cause a cord prolapse. The consultant took me straight into theater, and less than 2 hours after being told baby was transverse, he was born.

The consultant explained that provided there had been no other issues, they may have attempted to turn baby, or booked me in for ELCS, but due to the fact that my waters breaking was imminent, this is the reason for needing to be rushed to theater.

Fingers crossed for you that baby will move!

I had this twice. Ended up being induced a week early and had my waters broken in theatre so that I could be monitored for cord prolapse (ie if the cord came out first, it would have been a caesarean under GA). However in both instances all was fine and I had two normal (albeit heavily monitored!) vaginal deliveries. Good luck.

My daughter was a unstable lie from about 38 / 39 weeks. I was offered a CS or the option to stay in hospital until she either decided to move head down or a CS or emergency CS became necessary. I sat it out for nearly two weeks until she decided to turn. She was born later that same day.
Appaearantly not uncommon that they turn at the last minute. However not safe to leave hospital or even the ward in case waters break and/or labour starts with baby not in position.

Thanks all for sharing your experiences.

This is not something I’d even heard of or considered might be an issue so it’s thrown me completely. Especially as I was just sort of assuming I’d get lucky with a speedy and straightforward vaginal delivery like I had with dd.

I have a feeling that after the scan they’ll consider baby too unstable and want to keep me in, and then presumably book for a section at around 39 weeks? I really don’t want to be induced, and surely that would be risky as they don’t know what position baby will be in when the induction kicks in?

But The thought of staying in hospital for another week while dh is trying to juggle work and dd at home is a nightmare.

I just want to go home

Hi OP! I started a similar thread last week called transverse lie at 35+5. My baby was suddenly transverse last Wednesday. I'm booked in for another scan at 36+5. The registrar told me that the standard procedure if the baby is still transverse then is admission at 37 weeks and section at 39, although they would also offer an ECV.

Your situation sounds really hard, but you're absolutely in the best place! If the baby is unstable they should be keeping a close eye on its position during an induction (which you can refuse!!!) and do a CS if it's moving too much - this is exactly what happened to my SIL last week, and she is totally fine! Good luck!

I am as admitted at 38 weeks and had a planned section at 38+6. I was offered an ECV with immediate induction if it worked but declined this. When I was on the ward the midwives checked the baby's position every morning and if she had turned they would have induced me.

It was a tedious week but I felt safe and in the best place which for me was the most important thing. My baby had been transverse for most of my pregnancy and I was finding being at home increasingly stressful.

Thanks NC and keepon. I know really I’m in the best and safest place for baby. I’m just finding it really tough. Glad to hear all was well with your sil NC!

They’re checking baby’s position twice a day, and he’s just moving all over the place. The doctor said they might offer ecv if he’s Breech when they scan, but I don’t see the point as surely he’ll just move again?

The induction process can take hours / days to kick in right? So I just don’t see that being a viable option?

I wish the doctor had told me something similar about their standard procedure. Ie to admit and plan a section at 39 weeks or whatever. I hate the uncertainty. I’ve asked and asked but they just deflect saying let’s wait and see the result of the scan, it’s hard to say for definite now, we’ll review again... but nobody has actually said realistically it looks like you’ll have to stay in till we can do a section in a week’s time. If they told me this I could start to accept it. And also start working on childcare arrangements for dd!

The uncertainty is really difficult, I agree! I had accepted I'd have to be admitted but I think the baby has turned and then I got a bit confused... Even though the doctors can't offer you any certainty, you sound like you really don't want to be induced, and you don't sound keen on an ECV either. I'd say refuse both procedures and insist on a section. Then you can ask when they would do a section (I think usually at 39 weeks as that is safest). I know it's easier said than done though, I chickened out of discussing my hypnobirthing plans with the midwife and I'm quite assertive normally... I'd let DH sort out childcare. Any chance he could take some annual or parental leave?

Thanks NC.
Dh can take annual leave, and I’m lucky that my parents are nearby too so can help out with looking after dd. Usually she goes to a childminder a few days a week, but typically cm is on holiday this week!! As are my db and sil, who would be my other back ups!

I’m definitely going to refuse ecv and induction if I can. Ecv just seems pointless and induction too risky.

In my head I’m preparing to stay in for another week and a section at 39 weeks. But that is based purely on other mnners experiences! As no one here has given any indication!

Just sitting tight for now and waiting for my scan. But I really don’t know what it’s likely to tell us that we don’t already know.

Just had my scan. Baby is completely transverse. But volume of fluid is in the normal range, so not sure how he’s managing to swoosh about so much. Waiting for review by the doctor now. But don’t expect to be going home anytime soon.

Sorry to hear he is still transverse graysor. I hope the doctors give you a firm plan now. I don't have any other children so being in hospital was a bit different for me but I promise that the time did go quicker than I thought it would. I tried to break up the day with walks around the hospital, visitors in the afternoons and evenings and chatting to other ladies on the ward. I also ate a lot of toast!

Hi! Just wondering how you are? And where you are?

I saw the midwife today and she thought the baby was still transverse! The uncertainty sucks, can't wait to get some definite answers at the scan tomorrow (I hope!)

Hi NC!
Sorry to hear your baby is still transverse too! Hope you get a firm plan that you’re happy with after your scan.

Not much news to report from here. Baby is still super mobile, he’s moved to oblique and head down a few times, but then back again to transverse. Nobody knows how he’s managing to move so much . So I’m still just waiting on the antenatal ward.

The plan was to try ecv followed by induction on Wednesday. As when the doctor examined me on Tuesday morning baby was oblique and nearly head down so we figured it might be worth a go to shove him down into the right position. But they wanted to give me a hormone pessary for 24 hours first to make the cervix more favourable for induction afterwards. But they’ve been too busy to put it in. So now I don’t know when the ecv will be possible. And I think baby has flipped to transverse again .

Because we are both fine, generally low risk, with no other issues or complications we are lowest down on the priority list for being dealt with. Which is understandable, but very frustrating.

I miss my dd so much . Dh brought her in to visit on Sunday. She seems pretty unfazed by everything but it’s really hard for me. I had hoped to spend some nice quality time with her before her baby brother arrives. Instead I’ve barely seen her at all.

That must be so hard, not seeing your DD for so long. I do think kids tend to take these things in their stride though!

Can you nag somebody about the pessary? Surely it's not a complicated procedure? Might be wrong though! Good luck and keep us posted!

NCPuffin - what news from your scan today?

I have a bit of an update.
After a proper good cry with the midwife this morning I got a review with the consultant. When she examined me it seemed that baby has turned himself back to head down (at least for now). So it would be ok to start the pessary for the induction straight away.

The problem is, because baby is unstable and prone to moving around they have to do the pessary in the delivery ward, rather than antenatal. I guess because of the risk of waters suddenly going or something. So it was back to the waiting game for a room to become free, and for me to be top of the list to go.

i was worried I’d wait all day again, but amazingly fairly soon after they did move me to delivery. They’ve inserted the pessary, which can stay in for 24 hours I think. So now I wait, and hope my cervix cooperates!

And hope that he stays head down now!

Ooh, that's progress! Hope you're in labour soon.

So, our baby is... footling breech! Couldn't make it up, that was not one of the options we'd considered! The doctor recommended an ECV, which I've now got booked for Wednesday. I'll obviously have a scan before and during the procedure - I'm not holding my breath about the baby staying put ;). This is the safest option apparently (desperately trying to forget about an ECV horror story I read on here a while ago). It's successful about half the time, but when it does work the baby stays head down in 95% of cases. If it doesn't work I'll have a caesarean, as vaginal delivery isn't recommended with footling breech and I'm high risk and super anxious anyway. I'll keep you posted!

Hope things are happening for you graysor! Came across this thread while researching / ruminating on what lies in store for me, as suspected transverse lie got picked up by midwife today (36+2). Have a scan on Friday to confirm....but considering I can feel a bulge each side of my bump and not much at the bottom I'm not expecting the scan to say different! Sounds like I might have a tedious few days coming up. Guess it's not for long though in the grand scheme of things, and as long as baby arrives safely I don't care! All the best for tonight / tomorrow 😀

Good luck op - had this with all 3 of mine. Ended up with c-sections forvthem all and eldest 1s 16 and youngest 10! Wishing you all the best

I had this and had to have a planned C-section at 36+5 weeks.

Hi all, thought I should come and update.

So the pessary started working it’s magic and I was having regular contractions within a few hours. About 5 hours after they put it in the doctor did another scan to check baby was still in the right place.

While they were scanning baby did a full somersault, we watched him go from head down to transverse to breech!

Once he was breech they had to abandon the induction, so took the pessary out. They said that as long as the contractions stopped they would book me in for a c section in the next few days.

2 hours later the contractions were still coming every couple of minutes so they said we’d have to do a section straight away.

So ds was born by c section around 11 on Wednesday night.

We’re both fine and came home on Friday afternoon.

It certainly wasn’t the birth I’d hoped for, but no matter. I think I made the best decisions I could at the time. If I hadn’t had dd at home I think I’d have been more accepting of just sitting it out and waiting. But once you’re split between your existing children and a new one on the way it just felt impossible to sit and wait it out in the hospital.

Good luck to those of you with transverse and breech babies! I hope they are a bit more cooperative than my ds!!

Congratulations!

Mine has gone head down of her own accord but I've been admitted anyway with suspected preeclampsia. If it's not one thing it's another! Like you I'm grateful we are both well though disappointed not to have the nice chilled run in and natural birth I would have liked.