Effects of a Lateral Position With Hip Flexion and Femoral Internal Rotation During the Second Stage of Labor in Nulliparous Women Receiving Epidural Analgesia

NCT07745192 | Completed

• 1 other identifier: SAHoWMU-CR2024-07-118
• Study Type: interventional
• Target: 230
• Locations: 1 country
• Sites: 1

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.

Conditions

Delivery, Obstetric; Labor, Obstetric

Keywords

second stage of labor; epidural labor analgesia; maternal position; lateral position; hip flexion; femoral internal rotation

Outcome Measures

Primary Outcomes (2)

• 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

  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.

  During the second stage of labor

Secondary Outcomes (4)

• Duration of the First Stage of Labor

  From onset of regular uterine contractions to full cervical dilatation

• Duration of the Third Stage of Labor

  From delivery of the neonate to delivery of the placenta

• Postpartum Blood Loss

  Within 2 hours after delivery

• Perineal Outcomes

  At delivery

Study Arms (2)

Modified Lateral Position Group

EXPERIMENTAL

Participants in this group adopted a lateral position with hip flexion and femoral internal rotation during the second stage of labor under midwife assistance.

Behavioral: Lateral Position With Hip Flexion and Femoral Internal Rotation

Conventional Lateral Position Group

ACTIVE COMPARATOR

Participants in this group adopted the conventional lateral position during the second stage of labor under routine intrapartum care and midwife

Behavioral: Conventional Lateral Position

Interventions

Lateral Position With Hip Flexion and Femoral Internal Rotation BEHAVIORAL

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.

Modified Lateral Position Group

Conventional Lateral Position BEHAVIORAL

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.

Conventional Lateral Position Group

Eligibility Criteria

• Age: 22 Years - 34 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Second Affiliated Hospital of Wenzhou Medical University: lead

Study Sites (1)

Nanpu Branch of The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University

Wenzhou, Zhejiang, 325000, China

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 30, 2026
• First Posted: August 4, 2026
• Study Start: February 1, 2025
• Primary Completion: December 30, 2025
• Study Completion: December 30, 2025
• Last Updated: August 4, 2026

Record last verified: 2026-07

Locations

CN (1)