Lateral asymmetric decubitus position for the rotation of occipito-posterior positions: multicenter randomized controlled trial EVADELA

Predictors of successful manual rotation for occiput posterior positions

“…1,2,5,6 Methods suggested for managing occiput posterior position during labor include increasing uterine contractility, late use of epidural analgesia, and maternal positioning but none have been proven effective. [7][8][9][10][11] Manual rotation can be performed systematically when occiput posterior position is diagnosed, or only after failure to progress has been diagnosed. Several studies report that manual rotation reduces the rates of operative deliveries, severe perineal laceration, and postpartum hemorrhage.…”

Corrective effects of maternal extreme flexure and hip abduction combined with contralateral side‐lying on persistent foetal occipito‐posterior position

“…Our results indicated that the rate of successful correction was significantly higher and the duration between the initial correction and successful correction was significantly shorter in the study group than in the control group. Le Ray et al () reported that by full dilatation, the successful correction rate obtained by the lateral position was 4.3% more than achieved in a control group (ns) in 322 pregnant women with persistent foetal occipito‐posterior position. The successful correction rate in the study group of this study (at 87.6%) was higher than that of the control group of this study (at 65.7%) and in Le Ray's study, suggesting that maternal extreme flexure and hip abduction combined with contralateral side‐lying may be better than contralateral side‐lying alone for correction of the persistent foetal occipito‐posterior position.…”

“…Theoretically speaking, in the lateral asymmetric decubitus posture, foetal gravity, amniotic fluid buoyancy, and uterine contraction allow the foetal position to rotate from OP position to AP. However, it has been reported that the lateral asymmetric decubitus posture alone does not promote the rotation of the foetal head (Le Ray et al, ). Maternal extreme flexure and hip abduction can reduce pelvic inclination and can allow the sacral procurve to straighten, the sacrum to move back, the sacro‐coccygeal joint to widen, and the birth canal to straighten, which increases pelvic volume and may be conducive to correction of OP position.…”

Practices during the active second stage of labor: A survey of French midwives

“…Thus, in 2010, only 10 midwives in France had a PhD. Studies of midwifery care have recently begun to appear (Le Ray et al, 2016;, however, and are the beginning of the development of a culture of research and the appropriation of evidence-based midwifery by French midwives. A better description of midwives' practices in all countries will help us to understand how they affect the health of women and newborns by comparing national maternal and neonatal indicators.…”