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NCT Number: NCT07745192

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

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.

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Key information

Conditions

Delivery, Obstetric Labor, Obstetric

Age range

22 year–34 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

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

Wenzhou, Zhejiang, 325000, China

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

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.

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.

Primary outcomes

  1. Duration of the Second Stage of Labor

    Time frame: From full cervical dilatation to delivery of the neonate

  2. Additional Obstetric Interventions During the Second Stage of Labor

    Time frame: 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 outcomes

  1. Duration of the First Stage of Labor

    Time frame: From onset of regular uterine contractions to full cervical dilatation

    Duration of the first stage of labor, measured in minutes.

  2. Duration of the Third Stage of Labor

    Time frame: From delivery of the neonate to delivery of the placenta

    Duration of the third stage of labor, measured in minutes.

  3. Postpartum Blood Loss

    Time frame: Within 2 hours after delivery

    Postpartum blood loss, measured in milliliters.

  4. Perineal Outcomes

    Time frame: At delivery

    Perineal outcomes classified as intact perineum, episiotomy, first-degree perineal laceration, or second-degree or higher perineal laceration.

Sponsors and collaborators

Lead sponsor

Second Affiliated Hospital of Wenzhou Medical University

Other

Registry information

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Aug 4, 2026
Registry last updated
Aug 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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