The outcome of labour in primigravida with term gestation and unengaged head at onset of labour
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2016, Vol 3, Issue 3
Abstract
Introduction: Primigravida are the group at risk. As Ian Donald has said that “Primigravida is a dark and untrained horse and potential for child bearing is determined by the outcome of labour”. Labour is onset of regular uterine contraction followed by progressive cervical dilatation, effacement and descent of presenting part. Engagement is the first step in the mechanism of labour of a primigravida. Those with unengaged head at onset of labour are considered to be at high risk for operative delivery. Objective: To study the course of labour, need for intervention and fetal outcome in primigravida with unengaged fetal head at term gestation at onset of labour. Methods: A prospective study carried at Dept. of OBG at Rural medical college of Telangana state from July15 to Dec15. Total 120 primigravidas with unengaged head at term and at onset of labour were studied. Detailed history was taken in each case. General, systemic and obstetric examination was done. Ultra sonography was done in all cases and risk factors were ruled out. Cardio tocography (CTG) was done to know the fetal condition, partogram was used to monitor the progress of labour and interventions like augmentation and instrumental delivery. Results: Out of the 120 women, 91 women were in the range of 20-30 yrs, and 29 women were of less than 19 yrs. The mean duration of labour, 1st stage –(7hrs min 30 min to 10hrs 45 min) and 2nd stage (55 min to 110 min) out of total 120 cases 78 cases had vaginal delivery and 42 cases needed caesarean section. Among the 78 cases who delivered vaginally 14 cases had forceps delivery, 6 cases had vaccum assisted delivery and rest of the 58 cases had normal vaginal delivery. 42 cases required emergency LSCS, the commonest indication being failure of progress of labour. APGAR score was recorded at 5 min, 81 cases had APGAR score in the range of (7-10), in 33 babies APGAR score was (4-6), <3 APGAR score seen in 6 babies. 10 babies required NICU admission. Conclusion: Primigravida at term gestation with unengaged head at onset of labour should not be the sole indication for LSCS. Vaginal delivery is possible with watchful expectancy and usage of appropriate means of intervention.
Authors and Affiliations
Sunita Sudhir
Keywords
Related Articles
- EP ID EP241498
- DOI -
- Views 102
- Downloads 0
Clinical profile of STIs/RTIs in women in northwest Punjab
India is one of the most thickly populated countries of the world with a varied cultural background. Sexually transmitted infections/ Reproductive tract infections (STIs/RTIs) still remain a taboo amongst majority of the...
Effect of Yoga exercises on the course of pregnancy, labour and puerperium
Introduction: Pregnancy is a condition in which women undergo distinct physiological changes and stress. Also accompanied by unique physical and psychological demands, Yoga is thought to alter nervous system regulation a...
Bi-directional barbed suture in laparoscopic myomectomy: a clinical study
Objective: To evaluate efficacy and ease of use, of bidirectional barbed suture in laparoscopic myomectomy. Methods: One hundred and twelve cases of laparoscopic myomectomy were performed by a single surgeon over five ye...
Maternal complications of hypertension in pregnancy – A five year study
Introduction Hypertension is the most common medical problem encountered in pregnancy Approximately 18 of maternal deaths worldwide are due to hypertension complicating pregnancy For every woman who dies it is estimated...
Correlation of endometrial thickness by Trans-Vaginal Sonography [TVS] and histopathology in women with abnormal peri-menopausal and postmenopausal bleeding – A prospective study
Abnormal Uterine Bleeding (AUB) affects 50% of peri-menopausal women. It is common during the extremes of reproductive life, following pregnancy and also during lactation. About 10-15% of women experience AUB sometime du...