Evaluation of Asymmetrical Lateral Decubitus for Rotation of Occipitoposterior Fetal Position (EVADELA)

Assistance Publique - Hôpitaux de Paris

Status: Completed

Conditions: Fetal Occipitoposterior Position During the Labor

Treatments: Other: control; Other: Asymmetrical Lateral Decubitus

Study type: Interventional

Funder types: Other

Identifiers

NCT01854450

2012-A01578-35

P120902

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 326 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• women older than 18 years
• Gestational age ≥ 37SA,
• Ruptured membranes,
• single living fetus in cephalic presentation with an occipitoposterior position clinically diagnosed between 2 and 9 cm dilated and confirmed by ultrasound.
• Affiliation to a social security scheme (beneficiary or assignee)
• Signing the consent

Exclusion criteria

• Fetal presentation other than posterior
• Multiple pregnancy,
• Breech presentation
• History of previous cesarean section
• Fetal death in utero, termination of pregnancy
• Fetal intrauterine fetal growth restriction <5e percentile,
• Fetal malformation,
• Women younger than 18 years old,
• Women do not understand French,
• Women with psychiatric condition

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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326 participants in 2 patient groups

Asymmetrical Lateral Decubitus

Experimental group

Description:

Women in labor 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

Treatment:

Other: Asymmetrical Lateral Decubitus

control

Other group

Description:

usual obstetrical care

Treatment:

Other: control