Pregnancy unstable lie

What Is An Unstable Lie

You may have recently been told that you have an unstable lie or are concerned that you may have one, but you don’t know what that means. In plain terms, an unstable fetal lie is when your unborn baby moves positions within the womb during the later stages of pregnancy (after 36 weeks). This can be concerning for mothers-to-be, as they can suddenly move from a low risk to a more high risk pregnancy. When a baby is not head down it cannot be born vaginally and so if your baby won’t settle in the cephalic (head down) position or is moving between transverse (lying across your belly) to breech (bottom down) positions, if your waters break, then it can put you at increased risk of a cord prolapse.

An umbilical cord prolapse occurs when the umbilical cord slips in front of the baby once the waters have broken. From here, the cord can then enter the open cervix. When the cord prolapses through the cervix, it will sit between the baby and the outside world putting pressure on the vessels, reducing the amount of blood flowing through the cord and ultimately limiting the oxygen supply to the baby. If this occurs, it is considered an emergency and the baby will need to be delivered immediately in order to avoid any long-term harm or death of the baby. 

If you aren’t at a hospital when this occurs, it’s imperative that you call for an ambulance immediately and get onto your hands and knees, placing your chest on the floor and raising your buttocks. In this position gravity will help to keep the baby from pressing against the cord and cutting off the blood supply, which provides oxygen to the baby. If you arrive by ambulance or your waters break in hospital, we will check to see if the cord can be felt in the vagina and also ask you to adopt this position. A midwife or doctor may also place a hand in your vagina to lift your baby’s head away from the cord and will keep it there until your baby is able to be delivered safely. If the cervix is fully dilated and a vaginal birth is imminent, it may be safer and quicker to help your baby birth vaginally with an instrumental delivery. More likely in this type of an emergency, a cesarean delivery will be performed.

Unstable lie is more common in preterm babies as they are smaller and therefore have more space to move and so this is a normal finding prior to 36 weeks, so don’t worry if your baby is in different positions during scans prior to this point in pregnancy. Other causes of unstable lie which make it more likely for it to exist are:

• If it’s your first pregnancy
• If you have an irregular shape to your uterus (caused by fibroids or a septum)
• Twin pregnancy
• You are known to have a placenta covering the cervix (placenta previa)

Despite this, towards the end of pregnancy, the majority of babies will move into a head-down or cephalic position. This position enables the baby to pass through the birth canal when labour begins. If a head or a bottom is not presenting to the cervix you will need a caesarean as the baby cannot move through the pelvis in any other positions. For breech babies there are associated increased risks (see our breech blog for more). 

If an unstable fetal lie is identified, you may be offered the option to turn your baby to a head down position, using an external cephalic version (ECV), check out our breech blog for more on this. If this is successful, you would most likely be offered an induction of labour fairly soon after to ensure your baby doesn’t turn back. Different maternity units have different policies, but if you have been diagnosed with an unstable lie and you are over 39 weeks, it may be recommended that you remain as an in patient to avoid the risk of your waters breaking at home and having an umbilical cord prolapse. In cases where an ECV isn’t possible or successful, then a cesarean section will be recommended for the woman as the safest way to birth her baby. 

At The Birth Collective, we are able to provide you with antenatal support through our online courses that focus on all stages of pregnancy. We are here to answer all your questions through our courses and social media platforms, as well as ensuring that you have all the evidence-based information about what to expect. Contact our healthcare professionals to find out more or book onto one of our courses or webinars, today. If you have concerns about your pregnancy or health, please contact your own healthcare provider, as it’s important that this is managed by someone who knows your individual case in a timely way.

When a Person Is Told They Have an Unstable Lie

By: Gail Tully |

2020-01-29 |

Birth Anatomy,

Pregnancy,

Preparing for Birth

Lie means how the baby lies in the womb. The head-down baby is in a vertical lie, sometimes called cephalic to use a Latin term to mean the head is coming. Breech is an old English term to mean the baby’s pelvis is coming first. Both a head up (breech) and a head-down (cephalic) baby are in a vertical lie.
When a baby is lying across the abdomen or sideways, we say baby is in a “Transverse lie”. An oblique lie is when baby’s body is diagonal in the womb. The head or pelvis is towards one hip and the opposite “pole” or end of the baby is under the opposite rib. A baby in an oblique lie might have their head by the right hip and their bottom beneath the left ribs, for instance.

Using Spinning Babies® techniques for an Unstable Lie

Here’s a story of how Crista, a pregnant woman from Twin Cities, Minnesota, used Spinning Babies® recommended techniques to help her breech baby turn head down:
“I am 37 weeks pregnant with a breech baby who has flipped a couple of times, so I think he has an unstable lie. I was wondering what kind of options there are where I live…”
To help people in Crista’s situation, we offer a listing of Spinning Babies® Aware Practitioners, bodyworkers who understand fetal positioning when self-care isn’t enough. So Crista, not hearing back, took the initiative to explore the website, which is an excellent idea since my most common response is to suggest the website pages on flipping a breech!
Happily, Crista was the kind of person to initiate her life course. She tried the Forward-leaning Inversion. Her baby went head down, but baby came back to breech. The doctor tried to turn baby by pressing through her abdomen (External Cephalic Version, or ECV), but baby came back to breech.

Forward-leaning Inversion

She wrote, “My 38-week baby had flipped head down twice (once from Spinning Babies® and once from a version [ECV] at the hospital), but wouldn’t stay that way- what’s considered unstable lie. I was 5 days away from having a version at the hospital, if it worked they would have induced me. If not, C-section.”
About this time, I was able to call Crista and offer a plan for helping baby flip head down and gave her the name of a breech-skilled provider in our area.

Suggestions for Unstable Lie

The main thing I suggest for unstable lie is the same as for the persistent breech. Seven (7) Forward-leaning Inversions (FLI) in one 24 hour period, about 15 minutes to 2 hours apart. Do not set an alarm to wake yourself, sleep is paramount! Do not do FLI after eating or during heartburn. And see the page on Forward-leaning Inversion to avoid falls or a stroke. See the proper way to do it because the internet is full of pictures of the wrong way to do it.
Crista wrote, “Thanks so much for talking with me last night! I did a few Forward-leaning Inversions and Side-lying Release after we talked and then had a vivid dream about the baby flipping. Went in for an ultrasound this morning and that boy is head down! I could cry. Thank you so much for what you do, it is a gift.

Side-lying Release

Planning to wear the pregnancy belt and continue (one FLI a day) and Side-lying Releases (SLR) to keep him this way (and walking and sitting on the ball)- no ironing board inversions. Thank you, thank you, thank you!”
I replied, “Such good news! Wow! Walk, walk walk! With a good stride and shoes. If you do decide to induce, please consider one FLI the morning before starting the IV. The SLR and FLI can support the normal progress of labor, whether natural or induced. Remember their helpfulness before getting frustrated or tired. Same for pain, as this combination of techniques will also help reduce pain in labor.”
Crista agreed,  “Yes! There is no reason to induce now, so I’m just like every other pregnant lady waiting for labor to start. Thanks for the advice for during labor, I will do it!
I loved that your approach is so physiological and practical. My super, by-the-book OBGYN even recommended Spinning Babies® and she is usually very skeptical of anything outside medical guidelines. I wish everybody knew how much control you can actually have over how your baby interacts with your body! I am a believer and am excited to use some of the techniques during labor. Please share my story. I can’t thank you enough.”

Helpful Links:

• Find a Spinning Babies® Certified Parent Educator
• Find a Spinning Babies® Aware Practitioner
• Your Pregnancy Week-by-Week with Spinning Babies®
• Products for Parents
• Free Reading For Parents

False pregnancy in dogs - signs of what to do The reason is usually hidden in hormonal disorders that knock down the sexual cycle of a non-pregnant female, but not everything is always so clear.

What is the essence of this violation?

False or so-called pseudo-pregnancy can occur for various reasons. Some experts believe that the pet may have a tendency to this pathology. They explain this as follows: if the female dies after the birth of puppies, the offspring will not die of starvation, since another non-pregnant lactating dog comes out. nine0003

Indeed, it is very common for puppies to be fed by a stepmother, but this occurs in stray animals, but why does pseudopregnancy also occur in well-groomed pets?

From a medical point of view, a false pregnancy is a psychophysiological disorder caused by hormonal disorders. In theory, it can occur in any individual after puberty, and even sterilized bitches without ovaries are not immune from this if the operation was performed by a non-professional. nine0003

Pseudo-pregnancy develops during metestrus (after estrus), when the corpus luteum (the gland responsible for the production of special hormones) continues to work and lets the brain know that the body is ready for offspring, even in the absence of real fertilization. At the same time, the body is gradually preparing for the upcoming birth, despite the absence of embryos in the womb.

There are many reasons for the onset of the development of a false pregnancy, and the following most common ones can be distinguished among them:

• mating with castrated or neutered male;
• unstable psyche in an animal;
• close contact with a lactating or pregnant bitch;
• mating of a healthy dog ​​and a female with disorders in the reproductive or hormonal system.

The duration of pseudopregnancy can vary greatly. It is impossible to say for sure how long it will last. Most often this happens within 2-4 weeks.

How common is the problem? nine0009

According to statistics, approximately half of non-sterilized animals experience pseudo-pregnancy at least once during their life cycle. In some breeds, this occurs more often - in 75% of cases (hounds, dachshunds, beagles).

After an animal experiences a state of false pregnancy, the likelihood of a recurrence of the situation increases. Some animals experience this condition every time after estrus, if during this period they did not mate with anyone.

Occasionally, veterinarians note that many bitches develop symptoms of pseudo-pregnancy after an estrus cycle, but the symptoms are so diffuse and mild that they go unnoticed and go unnoticed by owners and treatment. At the same time, unidentified conditions also lead to behavioral problems, including aggressive conditions. nine0003

Symptoms of pseudo-pregnancy

Determining that an animal is truly pregnant is not so easy with the naked eye. In false pregnancy, many signs are exactly the same as in real pregnancy:

• mammary glands and nipples are swollen, colostrum begins to appear;
• edematous loop and discharge from it at times (light brown or transparent), and the animal licks them;
• belly enlarged as if there were puppies inside; nine0022
• Appetite worsens and vomiting may even occur, which is a bad symptom.

In addition to these physiological features, you can notice changes in mood: the dog is seriously preparing for the appearance of puppies. Behavioral factors that appear during pseudopregnancy include:

• Decreased motor activity. It may seem that the dog saves himself by refusing to jump from a height, run and perform other active actions familiar to him. nine0022
• Increased anxiety at the appearance of other animals, strangers, loud noises, etc.
• Nesting - the dog prepares a secluded place for offspring and spends a lot of time in it.
• Maternal instincts for various toys surrounding the dog and even people are manifested.

Not all of the listed features will necessarily be present. If there are several symptoms, the owner needs to be careful and it is advisable to go to the veterinary clinic in the Babushkinsky district or Medvedkovo, so that the doctors can do tests and identify the disease at an early stage. nine0003

Complications of false pregnancy in dogs

This condition of the animal is not associated with a high risk of adverse effects. The two most common problems are:

• inflammation or irritation of the skin in the nipple area;
• infection in the mammary glands.

These diseases should be treated by a specialist. If a dog often suffers from false pregnancy, it may develop uterine infections, pyometra, tumor processes. nine0003

Signs similar to pseudo-pregnancy can also be observed in other serious diseases, including benign pituitary tumors in the brain, hypothyroidism and pyometra. Other manifestations of the latter include vomiting, lethargy, and a foul odor from the animal's vagina. If one of these signs is detected, you need to quickly go to the veterinarian for diagnosis and treatment.

How to distinguish a false pregnancy from a real one?

This is not so easy to do, especially if you are not an expert, but there are several working methods that allow you to see the differences:

• A truly pregnant dog will never look for a replacement puppy. With a false pregnancy, the bitch can use some kind of toy for this.
• During pregnancy, hair thins around the nipples, but this does not happen with false processes.
• With false pregnancy, body temperature does not rise, and with real pregnancy, it jumps a week before the expected birth.

An accurate diagnosis is made only by a specialist. There are no home urine tests to check for pregnancy, so the only way to know for sure is to combine a test with tests and an ultrasound. nine0003

What to do about a false pregnancy?

If the dog shows only behavioral signs, no special treatment is required. When physiological problems are added to this (milk secretion or swelling of the nipples), veterinarians advise not to allow the dog to lick the glands. The owners should also not touch these areas, as this will stimulate lactation and may lead to infection.

It is better to put on a blanket or apply camphor oil on the nipples. It has an unpleasant odor that will repel the bitch from licking. Also, this method has another useful property in this situation - it suppresses lactation. When an animal is allergic or irritated to oil, the nipples should be rubbed superficially without treating the surrounding skin. nine0003

Some veterinarians believe that limiting water intake and changing the diet can help control milk production. The diet for pseudo-pregnancy may be as follows:

• on the first day you need to refrain from feeding;
• if using natural food, reduce the amount of meat and cereals in favor of boiled vegetables;
• dairy products should be removed from the diet;
• if dry food is used, you need to choose products marked "Light" - there is less protein in such food. nine0022

To reduce the stress of constant hunger, owners should not eat or prepare food in front of the dog. Along with the diet, experts advise active and long walks. You need to play more with the animal, communicate and distract it in every possible way so that the dog does not get hung up on the state.

Using Medications

If pseudopregnancy develops, your veterinarian may suggest medications to lower prolactin and stop your body from producing milk. These drugs have few side effects. As a rule, funds are given in courses of 5-10 days, but the duration of therapy is always determined by the veterinarian. nine0003

Previously, pseudopregnancy was often treated with hormones, including estrogens, androgens, progestogens. They created a lot of side effects that exceeded the benefits of therapy. For example, progestins often provoked pyometra.

Veterinarians usually prescribe mild sedatives that suppress aggression or anxiety. Diuretics may also be used to suppress milk production or reduce fluid retention in the body.

How to prevent a false pregnancy in a dog? nine0009

The only way to permanently eliminate pseudopregnancy in a bitch with a high degree of probability is neutering. If the owner does not plan to constantly bring her to breed puppies, it is sterilization that will be the most humane way to prevent false puppies.

It should be remembered that even after sterilization, this condition may occur if the operation was performed with symptoms of pseudopregnancy. The point is the surgical interruption of the natural hormonal cycle. That is why all experienced veterinarians recommend sterilization when the animal does not even have the slightest signs of a false pregnancy. nine0003

Common myths

Finally, let's look at a few popular misconceptions associated with pseudo-pregnancy. If you think that this condition will immediately pass if you scold the pet, you are mistaken. In reality, a dog's behavior is due solely to hormones that the animal cannot control. If you scold the animal, the situation can be aggravated.

Also, don't think that a false pregnancy can stop immediately if you remove its nest and all the toys that the animal takes for its puppies. These actions will not positively affect the state, but can have a bad effect on the mental state. nine0003

Some people believe that it is enough to tie a pet once, so that he does not have pseudo-pregnancy in the future. These actions will not change the situation, and even in this way, the symptoms of false pregnancies can be increased.

In the articles on the site you can find answers to many questions, learn the symptoms of a false pregnancy and ways to treat a false pregnancy. The changes that have occurred are the result of an increase in the amount of progesterone in the blood. The uterus and other organs may increase (purulent inflammation is also possible), it is difficult for the animal to move in the first month. For example, at home it is considered effective to increase the amount of exercise for a pet. nine0003

Posted in Care Tips

“This is something beyond, we are here like at war!”: Covid hit pregnant women

Report from the “red zone” of the RCH, where 83 expectant mothers are lying. Their lives are saved by early delivery

“There were cases of intrauterine fetal death: when a patient comes to us late, she had umbilical cord thrombosis from covid - here we can no longer help. And of those whom we managed to get by operational means, no one died. We have children weighing a thousand grams or less - and they are all alive!” — says Nigina Nigmatulina, head of the RCH perinatal center, explaining why the coronavirus is dangerous for expectant mothers and babies. Since July, a sharp influx of covid pregnant women has been recorded in the maternity hospital: intensive care units are overcrowded, drug therapy is limited, doctors are working with enormous overload. Correspondents of "BUSINESS Online" walked through the "red zones" of the maternity hospital and found out how expectant mothers are saved here from 80-95% lung damage.

“What is happening now is something beyond. It's like we're at war here. There have never been so many and so severe pregnant women in intensive care" Photo: Sergey Elagin

RCH: 83 pregnant women for 29 beds

RCH Perinatal Center has never specialized in easy delivery of healthy mothers. As the only third-level maternity hospital in Tatarstan that provides the most high-tech medical care, it has always collected the most severe cases from all over the republic. It would seem that nothing will surprise local doctors anymore, but covid succeeded: new strains began to hit pregnant women targeted, massively and cruelly. nine0003

“What is happening now is something beyond. It's like we're at war here. In intensive care, there have never been such a number and so severe of pregnant women "," says Nigina Nigmatulina, deputy chief physician of the Republican Clinical Hospital for obstetric and gynecological care , who heads the perinatal center. She says that at the beginning of the pandemic, 29 beds were provided for covid pregnant women, and today the number of such patients reaches 83, and the bed fund has to be increased proportionally. 10-12 women are admitted to the RCH every day - these are only those who have a severe form of the virus, or expectant mothers at a period of 22 weeks of pregnancy, the rest go to city hospital No. 7. By September, even more pregnant women are expected here. nine0003

“Vaccination started more than six months ago — we shouldn't see such an influx of covids now! Everybody! Everyone is coming from the hearth! You start to find out the anamnesis: they say that my mother is sick, my sister, my husband is sick, they all get together and infect the pregnant woman. Just recently, two sisters who live in the same apartment got into intensive care. One at 35 weeks, the other at 11 weeks pregnant!” Nigmatulina is outraged. She hurries to the temporary infectious diseases hospital (TIH), where a consultation will begin in the near future, and before that she needs to have time to once again dive into the "red zone" to a recently admitted patient in serious condition. nine0003

Expectant mothers attacked by the virus in the Republican Clinical Hospital are assigned to two buildings at once: most patients in a non-serious condition and not before childbirth are treated at the VIG, where a separate floor is allocated for them, and women in labor and those in need of intensive care are sent to the "red" perinatal isolation ward a center where neonatologists equipped with all the equipment, if necessary, can quickly help the baby in pediatric intensive care. One of the exceptions to this routing was Maria (hereinafter, the names of all patients have been changed at the request of the hospital management). Her condition, already extremely difficult due to severe covid, was complicated by failed kidneys. Therefore, she needs not just oxygen, but also dialysis, and the device is just in the temporary infectious diseases hospital. nine0003

— How to breathe today? Easier or harder?

Doctors conduct an examination, talk for a long time, study the medical history and indicators of the past day, make prompt appointments Photo: Andrey Titov

Maria smiles at the doctors from under the mask. She knows that she lost her child, but she does not seem to realize it until the end: neurocovid and hypoxia sometimes lead to a euphoric state , like a fuse, the body's defensive reaction is triggered. nine0003

- Was the pressure high?

- Yes, my life is high. I hate...

Doctors conduct an examination, talk for a long time, study the medical history and indicators of the past day, make prompt appointments. In a few minutes, the strategy for saving Mary will be discussed at a large council, for example, the question of opening a large hematoma on her stomach will be raised.

Such consultations are held constantly both in person and virtually. In the treatment of covid and ordinary people, you always have to involve specialists of various profiles, and it is doubly difficult to work with pregnant women. Their cytokine storm is much more severe, and they do not go to the doctor immediately, although the entire outpatient service conducts endless explanatory work with them. nine0003

“The course of covid is now so insidious that even when the clinic is mild, there are no complaints, we sometimes see a significant deterioration in laboratory parameters. Outwardly, the patient sits calmly, communicates with you, and the percentage of lung damage in her can be very high. Photo: Andrey Titov

« The course of covid is now so insidious that even when the clinic is mild, there are no complaints, we sometimes see a significant deterioration in laboratory parameters. Outwardly, the patient sits calmly, communicates with you, and the percentage of lung damage in her can be very high. nine0156 Only then does a breakdown occur when the lesions become fatal,” says Nigmatulina, explaining why absolutely everyone with confirmed covid is hospitalized, even if outwardly they seem healthy.