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Trial of Prophylactic Manual Rotation of Persistent Occiput Posterior Presentation During the Early Second Stage of Labor to Reduce Operative Delivery: a Prospective Multicenter Randomized Control Trial

Not Applicable
Conditions
Persistent Occipital Posterior Presentation During Labor Delivery
Interventions
Procedure: Prophylactic Manual Rotation of persistent occipital posterior presentation
Registration Number
NCT02695238
Lead Sponsor
Assistance Publique Hopitaux De Marseille
Brief Summary

Superiority multicenter prospective randomized study on operative delivery (instrumental delivery or caesarean section) of prophylactic manual rotation in case of persistent occipital posterior presentation during the second stage of labor compared to expectant management. A 15% reduction of operative delivery (instrumental delivery or caesarean section) is attempt in the prophylactic manual rotation group.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
260
Inclusion Criteria
  • Age ≥ 18 years
  • Singleton pregnancy
  • Term ≥ 37 weeks of gestation
  • Early second stage of labor
  • Rupture membranes
  • Persistent occiput posterior position confirmed by ultrasound
  • Epidural anesthesia
  • Patient who agree to participate and sign consent form
Exclusion Criteria
  • Age < 18 years
  • Term < 37 weeks of gestation
  • Vaginal and instrumental Delivery maternal contraindication
  • Antecedent of perineal injury type IV
  • Sensitive perineum
  • Crohn's disease with vaginal delivery contraindication
  • Instrumental fetal contraindication
  • Non reassuring fetal heart with impossibility of optimal maternal information
  • Known fetal malformation
  • Previous ceaserean section
  • Non cephalic presentation
  • Not affiliated to social security

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
prophylactic manual rotation groupProphylactic Manual Rotation of persistent occipital posterior presentationDuring persistent occipital posterior presentation during the second stage of labor, prophylactic manual rotation will be performed.
Primary Outcome Measures
NameTimeMethod
Number of patients who will have a caesarean section or an instrumental delivery in each groups.4 hours
Secondary Outcome Measures
NameTimeMethod
Number of patients with episiotomy, perineal lacerations from the 1st to the 4rth degree anglo-saxon classification4 hours
Number of patients who will have bladder, urinary or bowel injuries during caesarean section5 hours maximum
Number of patients with post-partum hemorrhage defined by blood loss more than 500mL5 hours maximum

Trial Locations

Locations (1)

Assistance Publique Hopitaux de Marseille

🇫🇷

Marseille, France

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