Early Diagnosis and Intervention for Fetal Malposition in Active Labor and Its Impact on Mode of Delivery: A Randomized Controlled Trial

What this Trial Is About

Researchers are investigating whether changing a laboring woman's position can increase the chances of delivering her baby vaginally, especially when the baby is facing upwards (occiput posterior) or sideways (occiput transverse). This randomized trial aims to determine if adopting a side-lying position with a peanut ball during active labor improves the likelihood of a spontaneous vaginal delivery and affects the baby's position at birth. The study also explores how these position changes influence the patient's sense of control during labor. Participants will be randomly assigned to one of two groups: one group will be asked to lie on their side on the same side as the baby's spine with a peanut ball placed between their legs for 60 minutes, while the other group will be allowed to choose any position without using a peanut ball during the same period. Ultrasound will be used during labor to confirm the baby's position and monitor any changes. The study focuses on women in active labor with specific fetal positions and cervical dilation between 6 and 9 centimeters. During the study, participants will receive ultrasounds to check the baby's position and will complete a questionnaire about their labor experience after delivery. Researchers will measure outcomes such as the rate of operative delivery (cesarean or assisted vaginal delivery), rotation of the baby to an optimal position, duration of labor stages, blood loss, degree of tearing, newborn health scores, and admission to neonatal intensive care. The total observation from enrollment through delivery is about 12 hours, with some follow-up assessments up to six weeks postpartum.

Early Diagnosis and Intervention for Fetal Malposition in Active Labor and Its Impact on Mode of Delivery