PRIMIGRAVIDA

Objectives: Determine the mode of delivery in primigravida with engagedversus unengaged fetal head with spontaneous onset of labour at term. Study design: Casecontrol study. Setting: Department of Obstetrics and Gynaecology, Lady Aitchison Hospital,Lahore. Duration of Study: Jan 2012 to Dec 2012. Patients and Methods: Two hundredcases 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 thosepresenting with unengaged fetal head were included in Group B. The course of labor in allpatients was recorded on partogram. Partogram was maintained according to departmentalprotocol. Cesarean section was decided if labour failed to progress or fetal head failed todescend after observing as per departmental protocol (12 hours). All patients were studiedin 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 and24.96+4.12 years in Group-B, 31%(n=31) in Group-A and 38%(n=38) in Group-B between37-39 weeks, 60%(n=60) in group-A and 51%(n=51) in Group-B between 40-41 weeks and9%(n=9) in Group-A and 11%(n=11) in Group-B were with 42 weeks of gestation, mode ofdelivery in primigravida with engaged versus unengaged fetal head with spontaneous onsetof 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) inGroup-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 inunengaged fetal head in primigravida women at term.