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

Active, not recruiting

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

• Registration Number: NCT06886854
• Lead Sponsor: Hospices Civils de Lyon

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-09-01
• Status Verified: 2025-03
• Study First Submitted: 2025-03-14
• Study First Submitted QC: 2025-03-14
• Last Update Submitted: 2025-03-14
• Study First Posted: 2025-03-20
• Last Update Posted: 2025-03-20
• Primary Completion: 2025-09-01
• Study Completion: 2025-12-01

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Male
• Target Recruitment: 1000

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

Exclusion Criteria

• • Multiparous uterus with scars
• Breech presentation
• Fetus > 5000 g
• Patient refusal
• Inadequate analgesia
• Fetal hypoxia

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Rate of eutocic deliveries	Collected at the time of delivery.	Collection of delivery data recorded by the midwife: eutocic delivery, instrumental extraction by vacuum, instrumental extraction by forceps, instrumental extraction by spatula, emergency cesarean section (green, orange, or red code).

Trial Locations

Locations (2)

Hopital de la croix rousse; 🇫🇷 France, France

Hopital Femme Mere Enfant; 🇫🇷 France, France