Outcome of primigravida with high head at term

Objective: To determine the progress of labour, need of medical and surgical intervention and foetal and maternal outcome in primigravida with high head at term Methods: The prospective descriptive study was conducted at the Department of Obstetrics and Gynaecology, Peoples University of Medical and Health Sciences, Nawabshah, Pakistan, from Jan 1 to June30, 2011, and comprised 100 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. SPSS 16 was used for statistical analysis. Result: Of the 100 women in the study, 70(70%) were aged between 20-30 years. The most common identified cause of non-engaged head was deflexed head in 28(28%), while no cause was found in 45(45%) women. Further, 45(45%) women presented with spontaneous labour, while labour had to be induced with prostaglandin in the rest. Vaginal delivery occurred in 59(59%) cases and caesarean section was performed in 41(41%). The duration of labour was 12 hours in 32(32%) cases. Postpartum haemorrhage affected 10(10%) patients, wound infection was seen in 7(7%), and perineal tear in 2(2%). Apgar score at 5 minutes was 7-10 in 75(75%), 4-6 in (20%), 3 and below in 5(5%) of neonates.