Shahida Malik, Uzma Asif, Midhat Asif.
Primigravida; obstetrical outcome; with engaged versus unengaged fetal head with spontaneous onset of labour at term.
Professional Med J Jan ;23(2):171-5.

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.

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