Maternal Positioning and Occipitoposterior Fetal Position

Study Overview
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Brief Summary
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The aim of the study is to evaluate the efficacy of a specific maternal position to correct fetal position in occipito-posterior during the labor. The investigators hypothesize that the maternal position described by the Dr de Gasquet facilitate the rotation in occipito-anterior during the labor. The calculated sample size is 438 participants (219 in each group)

Detailed Description
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Randomized clinical trial

Official Title
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Maternal Positioning to Correct Occipitoposterior Fetal Position in Labor: A Randomized Controlled Trial

Conditions
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Maternal Distress in Labor, Persistent Occipitoposterior or Occipitoanterior Position, Dystocia, Fetal Position and Presentation Abnormalities

Intervention / Treatment
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* Other: Specific maternal position during the labor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: singleton primiparous and multiparous Term ≥ 37 weeks Labor in dilatation phase (cervix effaced, permeable finger 2 to 9 cm) Diagnosis of occipitoposterior variety confirmed by ultrasound Exclusion Criteria: Maternal age below 18 years old Misunderstanding the French Language Full dilatation of the cervix Posture evaluated already adopted by the woman during labor

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 48 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Specific maternal position<br>women allocated to intervention group will be invited to adopt a posture all fours type:support on the knees, torso tilted forward, back stretched for a minimum of 10 minutes. A cushion is placed between the legs of the woman to limit the cuts. According to Dr de Gasquet, author of the description of this posture, the effect on the variety of presentation would be almost immediate. | Other: Specific maternal position during the labor<br>* women allocated to intervention group will be invited to adopt a posture all fours type:support on the knees, torso tilted forward, back stretched for a minimum of 10 minutes. A cushion is placed between the legs of the woman to limit the cuts.<br>|
| No Intervention: Control<br>Not specific intervention for this group- Only usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fetal presentation after the intervention compare to control group | Diagnosis of the fetal presentation will be measured by an ultra-sound one hour after the randomization in both groups: intervention and control | One hour after the randomization for the study | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maternal comfort and pain sensation | Auto-administrated questionnaire to assess comfort of the maternal position and pain related to the labor, in intervention group and control group | During the hour after the randomization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Labor, Maternal position, Occipitoposterior position, Dystocia, Fetal presentation Abnormalities