Evaluation of the Impact of Rotating Posterior and Transverse Presentations At 2 Hours of Full Dilation

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-09-01

Study Completion Date

2025-12-01

Brief Summary

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During labor, 20% of fetuses present in a posterior or transverse position. Among them, 90% rotate spontaneously during labor. For the remaining 10%, maintaining a posterior or transverse position leads to longer labor, increased instrumental deliveries, more cesarean sections, and more severe perineal tears. Obstetricians can intervene by manually rotating the fetus to an anterior position. Several studies have shown the benefits of this technique, but they were all conducted at full dilation or one hour after full dilation. This timing does not allow enough time for the fetus to rotate spontaneously. Additionally, manual rotation can be poorly tolerated by the patient, especially if pain management is insufficient.

Our study aims to demonstrate the benefits of manual rotation two hours after full dilation. This delay allows 90% of fetuses to rotate spontaneously, and it could help harmonize obstetrical practices.

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Detailed Description

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Conditions

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Fetus in Posterior or Transverse Position; Manual Rotation ; Obstetrics ; Delivery Room Practice

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Success of the rotation

Patients in labor with a fetus in posterior or transverse position at 2 hours of full dilation, verified by ultrasound. Manual rotation by an obstetrician after confirming effective analgesia, an empty bladder, and normal fetal heart rate. Success of the manual rotation

Mode of delivery

Intervention Type DEVICE

Retrieval of delivery data, typically recorded by midwives - retrieval of data per delivery and post-delivery - Consultation of medical data on labor duration, labor onset method, estimated fetal weight, etc.

Data collected for each delivery, identical in both groups.

Interventions

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Mode of delivery

Retrieval of delivery data, typically recorded by midwives - retrieval of data per delivery and post-delivery - Consultation of medical data on labor duration, labor onset method, estimated fetal weight, etc.

Data collected for each delivery, identical in both groups.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* \- Patient delivering at Hospices Civils de Lyon (XR, HFME, LS?)
* Low-pitched voice agreement
* Mobile fetal cephalic presentation
* Transverse or posterior presentation confirmed by ultrasound
* 2 hours of complete dilation
* Agreement for 3 hours by OB-GYN
* Normal fetal heart rate
* Epidural anesthesia in place
* Bladder catheterized