A 26-year-old primigravida at term presents with a transverse lie confirmed on ultrasound. Membranes are intact. The most appropriate management at this gestational age is:
- A External cephalic version (ECV) and await spontaneous labour
- B Planned cesarean section at 39 weeks or when labour begins ✓
- C Internal podalic version followed by vaginal breech delivery
- D Immediate induction of labour
Correct answer: B. Planned cesarean section at 39 weeks or when labour begins
Explanation
Transverse lie at term is an absolute contraindication to vaginal delivery; cesarean section is mandatory. ECV can be attempted before 36–37 weeks but is generally not recommended at term if the patient is in labour or if membranes rupture (cord prolapse risk). Internal podalic version is only used in selected cases during delivery of a second twin. Induction of labour in transverse lie risks cord prolapse and uterine rupture. Planned cesarean at or near 39 weeks (or emergent if labour begins) is the safe approach.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.