Abdominal Palpation-An Art in the Heart of Midwifery Practice to Determine Persistent Oblique Lie -A Rare Condition at Term Pregnancy

Persistent oblique lie is extremely rare and is frequently missed during antenatal care, despite the routine antenatal examination and obstetrics ultrasonography. An oblique lie is usually only transitory, however for either a longitudinal or transverse lie commonly result when labor supervenes. The main risk of an oblique lie is in association with preterm rupture of membranes and cord prolapsed. Abnormal lie of the fetus present the midwife with a challenge of recognition and diagnosis both in the antenatal period and during labour. The past obstetrical history and abdominal palpation may be of help. The assessment of fetal lie, position and presentation by abdominal palpation is a fundamental antenatal care skill, by which the midwife uses her hands to gently feel the position and presentation of the baby through the mother's abdomen, in order to assess which way the baby is lying in the uterus. The clinical purpose of this activity is to enable appropriate interventions to be offered and care to be planned. Here we report a rare case of persistent oblique breech with oligohydramnios and non progress of labour. This case report looks at how the art of midwifery is used as a cost effective method in screening the antenatal women at labour along with the use of sophisticated technology. Overdependence and abuse of ultrasound remains a problem and it should be emphasized that ultrasound is to complement and not a substitute to clinical judgment. The effects of ultrasound on the low-risk pregnancy need to be evaluated. The overuse of such technology can have detrimental effects, not only for the midwife but also for the woman in labour. While this technology has made a great impact in obstetric nursing.