ABSTRACT
The objectives of the study were to compare the progress of labour, need of medical and surgical interventions and fetomaternal outcome in primigravidae with non-engaged versus engaged fetal head at term or onset of labour. This study was performed at Services Hospital from July 2008 to December 2008. A total of 200 cases were studied over a six months period. Among these, 100 had engaged head and 100 had unengaged fetal head. Among these 100 women with unengaged head 62% had normal vaginal delivery and 38% had Caesarean delivery versus 85% normal vaginal delivery in engaged group. No etiology was found for unengaged fetal head in 46% cases. Duration of labour was prolonged and there was a greater need for active medical and surgical intervention in the unengaged group. There was no significant difference in maternal and neonatal morbidity between the two groups. Thus primigravidae with unengaged fetal head at term or onset of labour should be considered high risk and with proper monitoring and maintainence of partogram vaginal delivery is possible in majority with minimal fetomaternal morbidity