RESUMEN
Introduction Purpose: unengaged vertex in nulliparous in active labor, as confirmed by some studies is considered as a risk factor in cesarean section Considering the increasing rate of cesarean section in recent years and higher marbidity of cesarean section compared to vaginal delivery we tried to verify the relation between unengaged in vertex nulliparous in active labor and methods of delivery
Material and Methodes: This research was conducted between June 22 1999 to oct 22 2000 in delivery ward in IMAM Reza and HAZRAT ZAYNAB hospital . 100 nulliparous patient with unengaged vertex at the biginning of active labor were considered as the case group 100 other nulliparous patient with engaged vertex were chosen as control group. All the patient were singletons with the fetus between 37 to 42 week . They did not have pelvic contraction and the fetuses were not macrosomic for every patient was filled a questionnaire from the biginning of the active labor to the time of the delivery . The data obtained were analyzed using the fisher test and T test
Results: Of 100 cases of engaged vertex, there were 8 cases of cesarean section and 92 cases of vaginal delivery [Five cases due to fetal distress and three cases due to arrest and protraction disorders]
Of 100 cases of unengaged vertex there were 21 cases of cesarean section and 7 cases of vaginal delivery [9 cases due to fetal distress and 12 cases due to arrest and protraction disorders]
Conclusion: In nulliparous with unengaged vertex the risk of cesarean section increases. In such cases, therefore the need for conscious seach is clearly felt