Publication:

Labour outcome in primigravida with unengaged head: a observational study

Background Physiologically, labour is different in primigravida. It raises the apprehension of physicians. In the last two decades, the rising cesarean section rate is attributed to many factors, amongst which primigravida with the unengaged head is one of the significant cause. Objective were to study the labour outcome in a primigravida with unengaged head at term gestation in labourMethods: An institution based prospective study was conducted among 120 subjects. Primigravida with unengaged head at term gestation at the onset of labour were included. Pregnancy with pathological conditions of the fetus and maternal co-morbid condition were excluded. Intrapartum monitoring was done, and the partograph was plotted.

Results Amongst the study population, 49.2% (59) cases delivered by vaginal delivery. 58 (48.3%) cases were delivered by cesarean section.Non-progress of labour indicated cesarean delivery in most of the cases. In 34.4%of cases, non progress of labour was the indication for cesarean section. Duration of the first stage of labour ranges from 5-26 hours.

Conclusions Primigravida with unengaged head at early labour is not a direct indication for cesarean section. Intrapartum monitoring and the art of instrumental delivery can result in successful vaginal delivery.