Early Diagnosis and Intervention for Fetal Malposition in Active Labor and Its Impact on Mode of Delivery
Early Diagnosis and Intervention for Fetal Malposition in Active Labor and Its Impact on Mode of Delivery: A Randomized Controlled Trial
Who can join
Ages 18 and older · Women · Healthy volunteers welcome
Full eligibility criteria
Inclusion Criteria: * Maternal age \>18 * Term gestation (\>37 weeks) * Singleton pregnancy * Spontaneous or induced active labor (cervical dilation 6-9cm) * Epidural anesthesia * Cephalic fetal presentation, OP/OT position diagnosed by bedside ultrasound * Continuous external fetal monitoring * Ability to consent Exclusion Criteria: * Multiple gestations * Unanesthetized labor * Known fetal anomalies * Known intrauterine fetal demise * Inability to consent
About the study
The goal of this randomized trial is to test if changing a person's position in labor can increase the chances of delivering their baby vaginally.
Specifically, it aims to answer the questions:
* In fetuses who are facing upwards (occiput posterior, OP) or sideways (occiput transverse, OT) during labor, does changing the patient's position during active labor to a side-lying posture with a peanut ball increase the chances of them having a successful, spontaneous vaginal delivery? * Does changing the patient's position in active labor affect the position of the baby at the time of delivery? * Do intentional position changes in labor impact patient-perceived autonomy during their labor and delivery experience?
Participants will:
* Receive an ultrasound during labor to determine the position of their baby * Be asked to adopt a specific position in labor (side-lying with peanut ball) if they are randomized to the study group * Receive additional ultrasounds during labor to assess their baby's position * Fill out a questionnaire about their labor experience following the delivery of their baby
What is being tested
- Maternal position change to side-lying lateral with peanut ball (behavioral)
- Free maternal position (behavioral)
Sponsor: Women and Infants Hospital of Rhode Island · Participants: 200 · Started: May 1, 2024
Contact the study team
- Kathryn M Anderson, MD · Phone: 401-274-1100
Official record on ClinicalTrials.gov — NCT05881629
Locations in the U.S.
| Rhode Island | Women and Infant's Hospital of Rhode Island, Providence |
Conditions
From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.