PRIMIGRAVIDA

OBSTETRICAL OUTCOME; WITH ENGAGED VERSUS UNENGAGED FETAL HEAD WITH SPONTANEOUS ONSET OF LABOUR AT TERM

Abstract

Objectives: Determine the mode of delivery in primigravida with engaged
versus unengaged fetal head with spontaneous onset of labour at term. Study design: Case
control study. Setting: Department of Obstetrics and Gynaecology, Lady Aitchison Hospital,
Lahore. Duration of Study: Jan 2012 to Dec 2012. Patients and Methods: Two hundred
cases were included in this study and divided into two groups (A & B) 100 in each group.
Primigravidas presenting with engaged fetal head were included in Group A and those
presenting with unengaged fetal head were included in Group B. The course of labor in all
patients was recorded on partogram. Partogram was maintained according to departmental
protocol. Cesarean section was decided if labour failed to progress or fetal head failed to
descend after observing as per departmental protocol (12 hours). All patients were studied
in detail with reference to mode of delivery regarding vaginal (spontaneous and instrumental)
or cesarean section delivery. Results: Mean age was 23.65+3.72 years in Group-A and
24.96+4.12 years in Group-B, 31%(n=31) in Group-A and 38%(n=38) in Group-B between
37-39 weeks, 60%(n=60) in group-A and 51%(n=51) in Group-B between 40-41 weeks and
9%(n=9) in Group-A and 11%(n=11) in Group-B were with 42 weeks of gestation, mode of
delivery in primigravida with engaged versus unengaged fetal head with spontaneous onset
of labour at term was compared which showed that 19%(n=19) in Group-A and 39%(n=39)
in Group-B were delivered with cesarean section, 65%(n=65) in Group-A and 42%(n=42) in
Group-B were spontaneously delivered vaginally while 16%(n=16) in Group-A and 19%(n=19)
in Group-B had assisted vaginal delivery. Conclusion: Cesarean section was more prevalent in
unengaged fetal head in primigravida women at term.