This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
35 years old primipara in labour with transverse lie. Treatment of choice is - 
Select and explain. 
A. Internal cephalic version, B. Emergency cesarean section, C. Wait and watch, D. External cephalic version
B: Emergency cesarean section
Answer: B: Emergency cesarean section 
Explanation: Ans. is 'b' emergency caesarean section (Ref. Dutta, 6/e, p 397 (5/e, p 426 and p406)).Patients in labour with transverse lie are usually managed by external cephalic version followed by surgical rupture of the membrane.But the lady is an elderly primi so external cephalic version is contraindicated in her.This patient requires an emergency caesarean section.Contraindications of versionSevere preeclampsia or marked hypertensionPost caesarean pregnancyPlacenta previaSevere degree of contracted pelvisFetal malformationsElderly primigravidaeMultiple pregnancy.