Evaluation of the Impact of Rotating Posterior and Transverse Presentations At 2 Hours of Full Dilation

During labor, 20% of fetuses present in a posterior or transverse position. Among them, 90% rotate spontaneously during labor. For the remaining 10%, maintaining a posterior or transverse position leads to longer labor, increased instrumental deliveries, more cesarean sections, and more severe perineal tears. Obstetricians can intervene by manually rotating the fetus to an anterior position. Several studies have shown the benefits of this technique, but they were all conducted at full dilation or one hour after full dilation. This timing does not allow enough time for the fetus to rotate spontaneously. Additionally, manual rotation can be poorly tolerated by the patient, especially if pain management is insufficient. Our study aims to demonstrate the benefits of manual rotation two hours after full dilation. This delay allows 90% of fetuses to rotate spontaneously, and it could help harmonize obstetrical practices.

NCT Number	NCT06886854
Lead Sponsor	Hospices Civils de Lyon
Conditions	Fetus in Posterior or Transverse Position; Manual Rotation ; Obstetrics ; Delivery Room Practice
Enrollment	1,000 participants
Start Date	2024-09-01
Primary Completion	2025-09-01 (estimated)
Study Completion	2025-12-01 (estimated)
Updated on ClinicalTrials.gov	2025-03-20