Rubeena Badar Khan, Muntaha Sarosh, Kalsoom Waheed, Mahboob Alam Chishti, Zareen Amjad, Abid Hussain.
Outcome of primigravida with unengaged versus engaged foetal head at onset of labour.
J Allama Iqbal Med Coll Jan ;19(4):849-53.

Objectives: To compare the frequency of cesarean section in primigravidae who present with engaged foetal head and unengaged foetal head at the onset of labour. Methods: A total of 120 patients after admission in labour room at onset of labour were enrolled in the study keeping in view the inclusion criteria. Informed consent was taken. Patients with unengaged fetal head were placed in group A(n=60) and those with engaged fetal head in group B(n=60). Each patient was followed for the entire duration of labour according to standard protocol and course of labour was recorded on partogram. Caesarean section was performed in case of failed progress of labour, failed descent of head, non-reactive CTG (fetal distress) or meconium stained liquor. Frequency of caesarean section in both groups was noted. Labour outcome in terms of caesarean section and its indications were also evaluated. Data was entered in a predesigned proforma. SPSS version 21was used to analyze collected data. Results: Frequency of=cesarean section in d roup A (primigravidae with unengaged fetal head at onset of labour) was recorded as18% (n=11) while 82% (n=49) delivered vaginally. In the Group B (primigravidae with engaged fetal head at onset of labour) 8% (n=5) delivered by caesarean section and remaining 92% (n=55) delivered vaginally. Thus it shows a significant difference in the mode of delivery between the two groups. Conclusion: We concluded that the frequency of cesarean section in primigravidae with unengaged fetal head at onset of labour is significantly higher than engaged fetal head. Key Words: Primigravidae, engaged fetal head, Unengaged fetal head at term, cesarean delivery

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