ROTATE Rotation of the fetal head at full cervical dilatation

£17.96M GBP

Funder	National Institute for Health and Care Research
Recipient Organization	University College London
Country	United Kingdom
Start Date	May 01, 2021
End Date	Apr 30, 2025
Duration	1,460 days
Number of Grantees	2
Roles	Principal Investigator; Award Holder
Data Source	NIHR Open Data-Funded Portfolio
Grant ID	`NIHR127818`

Grant Description

RESEARCH QUESTION

For women at full cervical dilatation with persistent malposition of the fetal head requiring a rotational assisted vaginal birth, does manual rotation of the fetal head, compared to instrumental rotation with forceps or ventouse, reduce the risk of severe maternal perineal trauma without substantially increasing the risk of caesarean section?

BACKGROUND

Persistent malposition of the fetal head at full cervical dilatation affects 4% of women giving birth vaginally (30,000 per year in the UK) and is a strong predictor for poor maternal and neonatal outcomes such as anal sphincter injury (RR 1.25) and caesarean section (RR 4.4), with the raised risk of pre-term births in subsequent pregnancies (birth