Outcome of High Foetal Station in Primigravida With Vertex Presentation at Term - A Clinical Study in a Tertiary Care Center

Abstract

Introduction: There is an uncertain relationship between foetal station and mode of delivery. The rise in the rates of caesarean section in unengaged head in primigravida is due to the reason that high foetal station which is considered as a threat to normal progress of labor and so immediately considered as an indication to early caesarean section. A vigilant attitude and timely intervention can help in decreasing chances of C-section and help such cases deliver vaginally. Aims and Objectives: To study the outcome of unengaged head in full term primigravida in labor. 1. To evaluate the causes of unengaged head and analyse progress of labour. 2. To assess maternal and foetal outcome. Material and Methods: 124 Primigravidae at term with unengaged foetal head in labor were undertaken in the study after they met eligibility criteria. After history taking and clinical examination, course of their labor was monitored partographically to study the maternal and neonatal outcome. Results: Out of 124 patients, 84 (67.74%) patients had vaginal delivery while in 40 (32.26%) Lower Segment Caesarean Section (LSCS) was performed. Out of 84 vaginal deliveries, 64 patients had full term normal deliveries while 20 patients needed assisted instrumental deliveries. Thus, out of 124 deliveries, 64 (51.61%) had normal vaginal deliveries, 20 (16.12%) instrumental deliveries and 40 (32.25%) Caesarean sections. Conclusion: We can imply that primigravida at term with high foetal station with spontaneous onset of labor are not all for immediate caesarean section. Watchful expectancy, vigilant intrapartum partographic monitoring can result into normal vaginal delivery with minimal maternal and foetal complications.