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The objective of this study was to assess the effects of different maternal positions during electronic fetal monitoring (EFM) on maternal and fetal health outcomes. The study was conducted between December 2021 and January 2023 in a maternity hospital in Istanbul, employing a randomized controlled trial design. A total of 240 pregnant women were randomized into three groups: 60 participants were assigned to the right-side lying position (intervention 1), 60 to the semi-sitting position (intervention 2), and 120 to the left-side lying.
Maternal systolic blood pressure, body temperature, and pulse rate were measured before, during, and after the EFM procedure. Research data were collected through the Information Form and the General Comfort Scale-Short Form.
IIntroduction: Electronic fetal monitoring (EFM) is widely utilized for pregnancy and labor management due to its non-invasive nature, ease of use, and accessibility. However, the accuracy of EFM outcomes may be influenced by various factors, including the maternal position during monitoring, maternal comfort, and maternal blood pressure. This study aimed to explore how different positions during EFM influence both maternal.
Objective: The primary objective of this study was to examine the effects of three different maternal positions during EFM-right-side lying, semi-sitting, and left-side lying-on maternal and fetal health parameters. These parameters included systolic blood pressure, body temperature, pulse rate, and maternal comfort.
Methods:
A randomized controlled trial was conducted in a pregnancy follow-up outpatient clinic at a maternity hospital in Istanbul from December 2021 to January 2023. The study included 240 pregnant women, who were randomly assigned to one of three groups:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| intervention 1 | Experimental | electro fetal monitoring |
|
| intervention 2 | Experimental | electro fetal monitoring |
|
| control group | Experimental | electro fetal monitoring |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Right side lying position | Diagnostic Test | In the study, 60 participants were placed in the right side lying position (intervention 1) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Right Side Lying Post NST (3) | Blood Pressure (Systolic)-Blood pressure measurements were made before, during and after fetal monitoring of the pregnant women. | before NST |
| Measure | Description | Time Frame |
|---|---|---|
| Right Side Lying | Blood Pressure (Systolic) | NST instant |
| Measure | Description | Time Frame |
|---|---|---|
| Right Side Lying | Blood Pressure (Systolic) | post NST (NST time:1 minute) |
Inclusion Criteria:
Exclusion Criteria:
- The pregnant woman does not accept the recommended application position.
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| Name | Affiliation | Role |
|---|---|---|
| TUĞBA YILMAZ ESENCAN | Uskudar University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uskudar Univercity | Istanbul | Ümraniye | 34000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29772936 | Background | Humphries A, Mirjalili SA, Tarr GP, Thompson JMD, Stone P. The effect of supine positioning on maternal hemodynamics during late pregnancy. J Matern Fetal Neonatal Med. 2019 Dec;32(23):3923-3930. doi: 10.1080/14767058.2018.1478958. Epub 2018 Jun 3. | |
| 39773730 | Derived | Yilmaz Esencan T, Demir Yildirim A, Sagiroglu E. Effects of maternal positions in electronic fetal monitoring: a randomised controlled trial. BMC Nurs. 2025 Jan 7;24(1):22. doi: 10.1186/s12912-024-02654-w. |
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Randomization for the study was carried out on the website random.org; unique values were generated to divide 305 into 2 unique groups. The first group of 161 (81+81) numbers was randomly assigned to the intervention group, while the second group of 143 numbers was assigned to the control group.
December 2021 - January 2023
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| ID | Title | Description |
|---|---|---|
| FG000 | The Right Lateral Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| FG001 | The Semi-Fowler Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| FG002 | Control Group: the Left Lateral Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
The intervention group, comprising 120 pregnant women, was further divided into two subgroups: 60 women were assigned to the right lateral position, and 60 women to the semi-Fowler position. The control group, also consisting of 120 women, adhered to the clinic's routine practice of the left lateral position. All women in this group were placed in the left lateral position, with the remainder of the procedure conducted in the same manner as for the intervention groups.
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| ID | Title | Description |
|---|---|---|
| BG000 | Right Lateral Side-Lying Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Right Side Lying Post NST (3) | Blood Pressure (Systolic)-Blood pressure measurements were made before, during and after fetal monitoring of the pregnant women. | Posted | Geometric Mean | Standard Deviation | mmHg | before NST |
|
6 months
There was no risk for any pregnant woman in the study.There is no risk for pregnant women participating in the study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Intervention 1 | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
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In the limited number of similar studies in the literature, it has been the supine position that has been examined but this has not produced robust results. For this reason, differing from other studies, the present study sought to examine the effects of the right lateral position and BMI on maternal blood pressure and fetal health.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tugba YILMAZ ESENCAN | Uskudar Univercity | 05057084946 | tugba.yilmazesencan@uskudar.edu.tr |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Dec 18, 2019 | Sep 15, 2024 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Dec 18, 2019 | Sep 15, 2024 | SAP_001.pdf |
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The study was conducted in a pregnant follow-up outpatient clinic of a maternity hospital in Istanbul, between December 2021 and January 2023, in a randomized controlled experimental study design with two interventions and a control group. In the study, 60 participants were placed in the right side lying position (intervention 1), 60 participants in the semi-sitting position (intervention 2) and 120 participants in the left side lying position (control group), and the study was completed with a total of 240 pregnant women. Research data were collected through the Information Form and the General Comfort Scale-Short Form.
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|
| Semi Fowler | Diagnostic Test | In the study, 60 participants in the semi-sitting position (intervention 2) |
|
|
| left side lying position | Diagnostic Test | In the study, 120 participants in the left side lying position (control group). |
|
|
| BG001 | Semi-Fowler Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| BG002 | Left Lateral Side-Lying Position | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Geometric Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Body Mass Index | Body mass indexes of pregnant women were calculated. | Count of Participants | Participants |
|
| OG002 | Control Group | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). |
|
|
| Secondary | Right Side Lying | Blood Pressure (Systolic) | Posted | Geometric Mean | Standard Deviation | mmHg | NST instant |
|
|
|
| Other Pre-specified | Right Side Lying | Blood Pressure (Systolic) | Posted | Geometric Mean | Standard Deviation | mmHg | post NST (NST time:1 minute) |
|
|
|
| 0 |
| 60 |
| 0 |
| 60 |
| 0 |
| 60 |
| EG001 | Intervention 2 | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). | 0 | 60 | 0 | 60 | 0 | 60 |
| EG002 | Control Group | electro fetal monitoring Right side lying position: In the study, 60 participants were placed in the right side lying position (intervention 1) Semi Fowler: In the study, 60 participants in the semi-sitting position (intervention 2) left side lying position: In the study, 120 participants in the left side lying position (control group). | 0 | 120 | 0 | 120 | 0 | 120 |
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