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| ID | Type | Description | Link |
|---|---|---|---|
| 2012-A01578-35 |
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| Name | Class |
|---|---|
| URC-CIC Paris Descartes Necker Cochin | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Asymmetrical Lateral Decubitus | Experimental | 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 |
|
| control | Other | usual obstetrical care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Asymmetrical Lateral Decubitus | Other | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Fetal head position | fetal head position one hour after randomization | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| fetal head position | Clinical evaluation of the fetal head position at diagnosis of full cervical dilatation confirmed with ultrasound | at diagnosis of full dilatation |
| Speed of cervical dilatation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Camille Le Ray, MD, PhD | Port-Royal Maternity Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maternité du CH d'Avranches-Granville | Avranches-Granville | France | ||||
| CHU cĂ´te de nacre |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27242201 | Result | Le Ray C, Lepleux F, De La Calle A, Guerin J, Sellam N, Dreyfus M, Chantry AA. Lateral asymmetric decubitus position for the rotation of occipito-posterior positions: multicenter randomized controlled trial EVADELA. Am J Obstet Gynecol. 2016 Oct;215(4):511.e1-7. doi: 10.1016/j.ajog.2016.05.033. Epub 2016 May 27. |
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|
|
| control | Other | usual obstetrical care |
|
Duration of labor between randomization and full dilatation
| 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). | 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 | during and after labour |
| Caen |
| France |
| Port-Royal Maternity Hospital | Paris | 75005 | France |
| bluets maternity Hospital | Paris | France |