Effect of non-engagement of the fetal head in primigravida at onset of labour on the course and success of vaginal delivery

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

10.21608/aimj.2025.404582.2659

Abstract

Background: Labour is the process of delivering the fetus and placenta through regular, painful uterine contractions, causing cervical dilatation and fetal descent until delivery. Changes in the cervix and fetal position indicate labour progress.
Aim: To assess the influence of non-engagement of the fetal head in primigravida at the start of labour on the course and success of vaginal delivery.
Patients and methods: A cross-sectional analytical study has been carried out in the Obstetrics and Gynecology Department at El Hussein University Hospital, Al Azhar University, throughout the duration from September 2023 to July 2024. The study included 114 primigravida women at full-term gestation, who were separated into two groups: Group A (57 women) with unengaged fetal heads and Group B (57 women) with engaged fetal heads.
Results: A statistically insignificant distinction was found among the studied cases concerning the first stage of labor, shape of the pelvis, mode of delivery, fetal weight, and NICU admission. However, a statistically significant difference was observed in pelvic outlet and oxytocin augmentation. Additionally, there was a greatly significant variance in Apgar 1 scores and a significant variance in Apgar 5 scores among the groups.
Conclusion: With good induction of Labor there were no variance in delivery mode and result in primigravida with nonengaged fetal head. However, further studies must be performed on a large scale of cases in various races and countries.

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