Delivery, Obstetric, Labor, Obstetric
Conditions
Keywords
second stage of labor, epidural labor analgesia, maternal position, lateral position, hip flexion, femoral internal rotation
Brief summary
This randomized clinical study evaluated the effects of a lateral position with hip flexion and femoral internal rotation during the second stage of labor in nulliparous women receiving epidural labor analgesia. Participants were assigned to either an observation group using the modified lateral position or a control group using the conventional lateral position. The study compared second-stage labor duration, additional obstetric interventions, maternal outcomes, perineal outcomes, and neonatal outcomes between the two groups.
Interventions
BEHAVIORALLateral Position With Hip Flexion and Femoral Internal Rotation
Participants adopted a modified lateral position during the second stage of labor. The position involved lateral positioning facing the side opposite to the fetal back, hip flexion, knee flexion, and 30°-40° femoral internal rotation with midwife assistance. The position was used during uterine contractions with guided bearing-down efforts and was alternated with a semi-recumbent position according to the study protocol.
BEHAVIORALConventional Lateral Position
Participants adopted the conventional lateral position during the second stage of labor under routine intrapartum care and midwife assistance. During uterine contractions, participants performed bearing-down efforts in the lateral position, followed by intervals of rest and semi-recumbent positioning according to the study protocol.
Sponsors
Second Affiliated Hospital of Wenzhou Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
22 Years to 34 Years
Healthy volunteers
No
Inclusion criteria
* Nulliparous women. * Age 22 to 34 years. * Singleton pregnancy. * Cephalic presentation confirmed by ultrasonography after 37 weeks of gestation. * Gestational age of 37 to 41 weeks. * Estimated fetal weight of 2,500 to 3,500 g. * No birth-canal abnormalities on vaginal examination. * Effective epidural labor analgesia during the first stage of labor. * Sufficient cognitive capacity to understand and cooperate with the study procedures. * Ability and willingness to provide written informed consent.
Exclusion criteria
* Organic heart, liver, or kidney disease. * Prenatal indication for cesarean delivery. * Pubic symphysis separation. * Lower-limb disease or impaired mobility. * Precipitous labor. * Second stage of labor lasting less than 30 minutes. * Severe mental illness. * Fetal malformation. * Withdrawal from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of the Second Stage of Labor | From full cervical dilatation to delivery of the neonate | — |
| Additional Obstetric Interventions During the Second Stage of Labor | During the second stage of labor | Additional obstetric interventions during the second stage of labor, classified as none, forceps-assisted vaginal birth, cesarean delivery during the second stage, vaginal birth after manual fetal-head rotation, or vaginal birth with episiotomy as the principal intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of the First Stage of Labor | From onset of regular uterine contractions to full cervical dilatation | Duration of the first stage of labor, measured in minutes. |
| Duration of the Third Stage of Labor | From delivery of the neonate to delivery of the placenta | Duration of the third stage of labor, measured in minutes. |
| Postpartum Blood Loss | Within 2 hours after delivery | Postpartum blood loss, measured in milliliters. |
| Perineal Outcomes | At delivery | Perineal outcomes classified as intact perineum, episiotomy, first-degree perineal laceration, or second-degree or higher perineal laceration. |
Countries
China
Outcome results
None listed