Publication:

Outcome of high fetal station in Primi-Gravida at term in labour

Background Labour is an important event with unique experience exclusively in a woman’s life, which gives her the greatest satisfaction by delivering her own child, the wonder creation of master craftsman! The objective of the study was to know the effect of station of fetal head in early labour and its significance, to assess the course and duration of labour in relation to station of head at the onset of labour and to study the maternal and neonatal outcome.

Methods The prospective descriptive study was conducted at the Department of Obstetrics and Gynecology, LD Hospital, Government medical college, Srinagar on 150 primigravida with unengaged head at term and at onset of labour. Detailed history was taken in each case and general, systemic and obstetric examination was done. Pelvic assessment and ultrasonography was performed.

Results Of the 150 women in the study, 110 (70%) were aged between 20-30 years. The most common cause of un-engaged head was deflexed head in 42 (28%) women, Cephalopelvic disproportion (CPD) in 20 (13.34%), loop of the cord around the neck in 9 (6%), placenta previa type in 8(5.33%) whereas no cause could be identified in 60 (40%) Further, Only 67 (44.67%) women presented with spontaneous labour, and the rest were induced with prostaglandin or with intra-cervical Foleys catheter for varied reasons. Vaginal delivery occurred in 89 (59.33%) cases and caesarean section was performed in 54 (36%). The duration of labour was <12 hours in 32 (32%) cases. Postpartum hemorrhage (PPH) occurred in 16 (10.67%) women, perineal tear in 5 (3.33%), wound infection in 8 (5.33%). Apgar score at 5 minute was 7-10 in 113 (75.33%), 4-6 in 30 (20%), 3 and below in 7 (4.67%) neonates.

Conclusions The primigravida with unengaged head at term during labour should be regarded with suspicion and the same woman in labour should be regarded with apprehension. Labour appeared to be dysfunction in only small proportion of the patients with unengaged head.