Evaluation of the Impact of Rotating Posterior and Transverse Presentations At 2 Hours of Full Dilation
This study is about helping babies turn inside the womb during labour if they're not in the ideal position for birth. Sometimes, a baby might be facing the wrong way (posterior) or lying sideways (transverse), which can make labour longer or lead to more interventions like C-sections. While most babies turn on their own, some don't. Doctors can gently help turn the baby by hand. This study wants to find out if waiting two hours after the cervix is fully open (dilated) to do this manual turn is better. The idea is that this wait gives the baby more time to turn naturally, and could make the process smoother for everyone.
At a glance
What is this study about?
When you're in labour, most babies naturally get into a head-down position, facing your back. This is the easiest way for them to be born. However, about one in five babies might be facing the other way (posterior position) or even lying sideways (transverse position) when labour starts. Often, these babies will turn by themselves into the right position during labour, about 9 out of 10 times.
For the babies who don't turn on their own, labour can be tougher. It might take longer, or there could be a higher chance of needing help with forceps or a vacuum, or even needing a C-section operation. It can also lead to more serious tears for the mum during birth. Doctors can try to gently turn the baby by hand inside the womb to help them get into a better position. This is called a 'manual rotation'.
This study is looking into the best time to do this manual rotation. Previous studies have shown that turning the baby by hand can be helpful. However, those studies often did the turn as soon as the cervix was fully open or very soon after. This study wants to see if waiting two hours after your cervix is fully open is a good idea. The researchers believe that this wait gives more babies the chance to turn naturally first. If fewer manual turns are needed, it could make labour a better experience for mothers and help doctors consistently provide the best care.
Key takeaways
- Most babies turn into the best birthing position naturally.
- This study explores if waiting longer before intervening helps babies turn on their own.
- It investigates the best timing for a gentle manual rotation by a doctor.
- The goal is a smoother labour and delivery for mums and babies.
- Participation involves care during labour at specific French hospitals.
Who may be eligible?
This study is looking for pregnant people who are giving birth at specific hospitals in Lyon, France (Hospices Civils de Lyon). You might be able to take part if your baby is in a head-down position but is facing the wrong way (posterior) or is lying sideways (transverse), and this has been confirmed by an ultrasound scan.
To be included, your cervix needs to be fully open (fully dilated) for two hours. You would also need to have an epidural for pain relief, have a normal fetal heart rate, and have a catheter in your bladder. The research team will explain everything and make sure you understand before you agree to take part.
However, you wouldn't be able to join if you've had a C-section before, if your baby is in a bottom-first (breech) position, if your baby is estimated to be very large (over 5kg), or if you already have inadequate pain relief. If there are any concerns about your baby's oxygen levels (fetal hypoxia) or if you decide you don't want to participate, you also wouldn't be included.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you giving birth at one of the participating hospitals in Lyon, France?
- Is your baby in a head-down position but facing the wrong way or lying sideways?
- Do you have an epidural in place for pain relief?
- Is your baby's heartbeat normal?
- Have you had a C-section before? (A 'no' might mean you're eligible)
What does participation involve?
The study aims to observe whether naturally waiting for two hours after full dilation (when your cervix is completely open) before intervening helps with baby position during labour. It is important to note that the study information provided does not detail specific extra visits or assessments beyond what is typically expected during labour and delivery. The main aspect of participation would involve a potential manual rotation by your obstetrician if your baby has not turned on its own after two hours of full dilation. This would be part of your delivery room care. There are no additional medications mentioned as part of the study. The total duration of your participation would be limited to your labour and delivery process.
Potential risks and benefits
Locations (2)
- Hopital de la croix rousseVerified postcodeFrance, France
- Hopital Femme Mere EnfantVerified postcodeFrance, France
Common questions
What does 'posterior position' mean for my baby?
It means your baby is head-down, but facing your tummy instead of your back. This can sometimes make labour longer.
What is 'manual rotation'?
It's when a doctor gently places their hand inside the womb to help turn the baby into a better position for birth.
Why wait two hours after full dilation?
The study suggests that waiting gives your baby more time to turn into the correct position by themselves, possibly reducing the need for help.
Will taking part impact my baby's delivery?
The study is looking at the timing of an intervention that might happen anyway if your baby doesn't turn. The aim is to find the best approach for a safer delivery.
Who is running this study?
This study is being run by researchers at the Hospices Civils de Lyon in France.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
Discussion
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