Outcome of Labor in Nullipara at term with Unengaged vertex | ||||
Zagazig Nursing Journal | ||||
Article 14, Volume 10, Issue 2 - Serial Number 2014, 2014, Page 218-233 PDF (302.76 K) | ||||
Document Type: Original Article | ||||
DOI: 10.12816/0029159 | ||||
View on SCiNiTO | ||||
Authors | ||||
Hemmat Moustafa Abdel Mageed1; Sanaa Ali Nour2; Hend Salah El-Din3; Amany Hamed Gad4 | ||||
1Clinical instructor in Obstetrics and Gynecological Nursing- Faculty of Nursing- Zagazig University | ||||
2Professor of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University | ||||
3Assist. Prof. of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University | ||||
4Lecturer of Obstetrics and Gynecological nursing- Faculty of Nursing- Zagazig University | ||||
Abstract | ||||
Background: Unengagement of the head in primigravida has long been considered a possible sign of cephalopelvic disproportion. It is associated with a higher risk of obstructed labor. The aim of this study was to; assess outcome of labor in nullipara at term with unengaged vertex. Setting this study was conducted in labor and premature Hospital at Zagazig Maternity Hospitals. Subjects: a representative sample of 200 parturient women (100 had engaged head and 100 had unengaged fetal head) was recruited for this study. The tools used for data collection were; an interview questionnaire sheet, a clinical assessment form, the partograph, a summary of labor sheet and a neonatal assessment sheet. The results of the present study revealed that in more than three fifth (63.0%) of women with unengaged head the cause was unknown but it was most common among those with deflexed head (25.0%), they also had significantly longer first stage of labor (p=0.000). Cesarean section rate was significantly found to be more in the unengaged group being 35.0%. Most of the C-sections were carried out due to failed labor progress (76.9%). Patients with unengaged fetal head had significantly lower Apgar scores in 1st (p=0.000) and 5th min (p= 0.446). Conclusion: It can be concluded that, patients with unengaged vertex are at higher risk for cesarean delivery due to arrest disorders as well as lower fetal APGAR scores. Recommendations: The study recommended that, the watchful expectancy and timely intervention, especially in cases where no etiological factor is found, by blotting a partogram and using oxytocin judiciously when labor appears to be taking a protracted course, most of the women with unengaged head will deliver vaginally with minimal maternal and fetal morbidity. | ||||
Keywords | ||||
engaged; unengaged; nullipara; Outcome | ||||
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