Maternal and perinatal mortality and morbidity associated with transverse lie

The aim of this study of transverse lie in labor of patients admitted to Korle Bu Hospital between 1 January 1996 and 30 June 1998, was to identify the methods of delivery, the perinatal and maternal morbidities and mortalities, and to provide recommendations to improve the outcome.

This was a retrospective study of 152 patients who presented at the labor wards with transverse lie. The data sources of this study were the antenatal records, the labor wards delivery record books, the postnatal records and the admission books at the Neonatal Intensive Care Unit.

One hundred and forty-two cases (92.1%) had an emergency cesarean section. The rest had the external version followed by vaginal delivery. There were two maternal deaths resulting from hemorrhage, infections and difficult surgery. There were 25 stillbirths, and 37 of the neonates required hospital admission.

Transverse lie carries a high rate of complications in labor. Delivery should be carried out without delay in a hospital well-equipped for cesarean delivery and assisted vaginal delivery. The complications could be further reduced by early diagnosis during the antenatal period when associated risk factors, such as placenta previa could be diagnosed with the aid of the ultrasound scan. Elective deliveries could then be undertaken.