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.

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.