1. UNSTABLE LIE

2. Definition
It is a condition in which the presentation of the fetus is constantly changed even beyond 36th week of pregnancy when it should have been established.

4. Causes
Are the factors which prevent the presenting part to remain fixed in the lower pole of the uterus
Grand multipara with lack of uterine tone and pendulous abdomen
Hydramnios
Contracted pelvis
Placenta previa
Pelvic tumor

5. Management Antenatal Check presentation and lie of the fetus
External version if not contraindicated
Hospitalisation
Admit at 38th week
Do investigations to exclude placenta previa, contracted pelvis or congenital malformation of the fetus

6. Formulation of line of treatment
Elective LSCS
In the presence of complicating factors
Stabilising induction of labour
In the absence of complicating factors
The principle is to secure uterine activity and to perform amniotomy

7. Procedure for stabilizing induction of labour
Check presentation and do external cephalic version
Start oxytocin drip
Do internal examination
Do low rupture of membrane
Continue usual management

8. THANK YOU