Maternal posturing is used during labor to facilitate the rotation of occipitoposterior fetal position in anterior. Our study aims to evaluate the efficacy of asymmetrical lateral decubitus for rotation of the fetal head.
The prevalence of fetal occipitoposterior position during labor is 20%. Compared to anterior positions, they are known to be at higher risk of complications (cesarean section, instrumental delivery, severe perineal laceration). Maternal posturing is used during labor to facilitate the rotation of the fetal head in anterior position. Asymmetrical lateral decubitus is used frequently, without having ever been evaluated. Our study aims to evaluate the efficacy of this maternal posturing, through a randomized open trial. We hypothesized that posturing women in asymmetrical lateral decubitus allows increasing frequency of anterior fetal position after 1 hour.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
326
After randomization, women are postured in pronounced lateral decubitus (side opposite to the back of the fetus), with the inferior leg in extension, and the superior leg in hyperflexion, during 1 hour (minimum 30 minutes). Then, women are encouraged to take this posture during labor as frequently as possible if the fetus remains in occipitoposterior position
usual obstetrical care
Maternité du CH d'Avranches-Granville
Avranches-Granville, France
CHU côte de nacre
Caen, France
Port-Royal Maternity Hospital
Paris, France
bluets maternity Hospital
Paris, France
Fetal head position
fetal head position one hour after randomization
Time frame: 1 hour
fetal head position
Clinical evaluation of the fetal head position at diagnosis of full cervical dilatation confirmed with ultrasound
Time frame: at diagnosis of full dilatation
Speed of cervical dilatation
Duration of labor between randomization and full dilatation
Time frame: during the first stage of labour
Mode of delivery and perineal complications
Mode of delivery (spontaneous vaginal, instrumental vaginal delivery, cesarean section) and perineal complications (episiotomy, severe perineal tears).
Time frame: at delivery
feasibility and acceptability of asymmetrical lateral decubitus
quality of fetal heart rate monitoring during maternal posturing Evaluation of maternal satisfaction using self-administered questionnaire
Time frame: during and after labour
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