{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T07:07:49Z","timestamp":1779088069787,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unstable fetal lie, characterized by frequent changes in fetal presentation during late pregnancy, poses challenges in pregnancy management and delivery planning. We aimed to examine the obstetrical and neonatal outcomes associated with term pregnancies complicated by an unstable fetal lie.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included data recorded during 2012\u20132022 of women with term singleton pregnancies with an unstable fetal lie who attempted vaginal delivery after stabilizing to vertex. We compared their obstetrical and neonatal outcomes in a 1:2 ratio to those of women without a history of unstable fetal lie who had a singleton fetus in vertex presentation at delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 67,360 deliveries, 174 (0.25%) were with an unstable fetal lie. For women who attempted vaginal delivery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116, 66.7%) compared to women with spontaneous vertex presentation who delivered vaginally (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009232), the intrapartum cesarean delivery (CD) rate was higher (31.0% vs. 10.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Also higher were the CD rates attributed to fetal distress (12.9% vs. 6.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038) and labor dystocia (11.2% vs. 4.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041), and the nuchal cord incidence rate (17.2% vs. 5.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate logistic regression identified unstable fetal lie as an independent risk factor for emergent CD (OR 4.1, 95% CI 2.1\u20138.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Birth trauma, cord prolapse, and perinatal death were not reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vaginal delivery attempts in women with an unstable fetal lie did not show similar progression of labor and obstetrical outcomes as spontaneous vertex presentation. This emphasizes the need for tailored management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70076","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:20:02Z","timestamp":1779085202000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obstetrical and Neonatal Outcomes of Term Pregnancies Complicated by Unstable Fetal Lie"],"prefix":"10.1111","author":[{"given":"Abdalla Abu","family":"Zrake","sequence":"first","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Odeh","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"},{"name":"Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raneen Sawaid","family":"Kaiyal","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2169-2977","authenticated-orcid":false,"given":"Ala","family":"Aiob","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"},{"name":"Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lior","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"},{"name":"Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5270-8436","authenticated-orcid":false,"given":"Inshirah","family":"Sgayer","sequence":"additional","affiliation":[{"name":"Raya Strauss Wing of Obstetrics and Gynecology Galilee Medical Center  Nahariya Israel"},{"name":"Azrieli Faculty of Medicine Bar Ilan University  Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/B978-1-4160-5908-0.00064-8","volume-title":"High Risk Pregnancy","author":"MacKenzie I. Z.","year":"2011"},{"key":"e_1_2_8_3_1","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG) \u201cUmbilical Cord Prolapse. Green\u2010Top Guideline No. 50 \u201d(2014) https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/gtg\u201050umbilicalcordprolapse\u20102014.pdf."},{"key":"e_1_2_8_4_1","unstructured":"Government of Western Australia \u201cAbnormalities of Lie\/Presentation. Clinical Practice Guidelines \u201dhttps:\/\/www.kemh.health.wa.gov.au\/~\/media\/HSPs\/NMHS\/Hospitals\/WNHS\/Documents\/Clinical\u2010guidelines\/Obs\u2010Gyn\u2010Guidelines\/Abnormalities\u2010Of\u2010Lie\u2010Presentation.pdf?thn=0."},{"issue":"496","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1136\/pgmj.43.496.92","article-title":"Unstable Lie in Pregnancy and in Labour","volume":"43","author":"Bancroft\u2010Livingston G.","year":"1967","journal-title":"Postgraduate Medical Journal"},{"issue":"8","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/j.1471-0528.1969.tb06163.x","article-title":"The Management of the Unstable Lie in Late Pregnancy","volume":"76","author":"Edwards R. L.","year":"1969","journal-title":"Journal of Obstetrics and Gynaecology of the British Commonwealth"},{"issue":"1","key":"e_1_2_8_7_1","first-page":"34","article-title":"Management of Unstable Lie During Late Pregnancy and Labour","volume":"3","author":"Banjoko M. O.","year":"1973","journal-title":"Nigerian Medical Journal"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.ejogrb.2017.12.041","article-title":"Management of Unstable and Non\u2010Longitudinal Lie at Term in Contemporary Obstetric Practice","volume":"221","author":"Cuffolo R.","year":"2018","journal-title":"European Journal of Obstetrics, Gynecology, and Reproductive Biology"},{"issue":"1","key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/01.AOG.0000129240.54949.d2","article-title":"Intrapartum Cesarean Delivery After Successful External Cephalic Version: A Meta\u2010Analysis","volume":"104","author":"Chan L. Y.","year":"2004","journal-title":"Obstetrics and Gynecology"},{"issue":"6","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/jp.2015.220","article-title":"Intrapartum Intervention Rates and Perinatal Outcomes Following Successful External Cephalic Version","volume":"36","author":"Basu A.","year":"2016","journal-title":"Journal of Perinatology"},{"issue":"6","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1097\/AOG.0000000000000295","article-title":"Mode of Delivery After Successful External Cephalic Version: A Systematic Review and Meta\u2010Analysis","volume":"123","author":"Hundt M.","year":"2014","journal-title":"Obstetrics and Gynecology"},{"issue":"4","key":"e_1_2_8_12_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jogoh.2020.101693","article-title":"Obstetrical and Neonatal Outcomes After Successful External Cephalic Version Relative to Those After Spontaneous Cephalic Presentations","volume":"49","author":"Chevreau J.","year":"2020","journal-title":"Journal of Gynecology Obstetrics and Human Reproduction"},{"issue":"2","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/AOG.0b013e31822545a9","article-title":"Timing of Delivery After External Cephalic Version and the Risk for Cesarean Delivery","volume":"118","author":"Kabiri D.","year":"2011","journal-title":"Obstetrics and Gynecology"},{"issue":"7","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1080\/00016340500345428","article-title":"Obstetrical Factors Related to Nuchal Cord","volume":"85","author":"Ogueh O.","year":"2006","journal-title":"Acta Obstetricia et Gynecologica Scandinavica"},{"issue":"3","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/s41372-019-0511-x","article-title":"The Effect of Nuchal Cord on Perinatal Mortality and Long\u2010Term Offspring Morbidity","volume":"40","author":"Masad R.","year":"2020","journal-title":"Journal of Perinatology"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70076","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.70076","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:20:07Z","timestamp":1779085207000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.70076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,17]]},"references-count":14,"alternative-id":["10.1111\/birt.70076"],"URL":"https:\/\/doi.org\/10.1111\/birt.70076","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,17]]},"assertion":[{"value":"2023-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"birt.70076"}}