Outcome of Labor in Nullipara at term with Unengaged vertex
Abdel Mageed, H., Nour, S., El-Din, H., Gad, A. (2014). Outcome of Labor in Nullipara at term with Unengaged vertex. EKB Journal Management System, 10(2), 218-233. doi: 10.12816/0029159
Hemmat Moustafa Abdel Mageed; Sanaa Ali Nour; Hend Salah El-Din; Amany Hamed Gad. "Outcome of Labor in Nullipara at term with Unengaged vertex". EKB Journal Management System, 10, 2, 2014, 218-233. doi: 10.12816/0029159
Abdel Mageed, H., Nour, S., El-Din, H., Gad, A. (2014). 'Outcome of Labor in Nullipara at term with Unengaged vertex', EKB Journal Management System, 10(2), pp. 218-233. doi: 10.12816/0029159
Abdel Mageed, H., Nour, S., El-Din, H., Gad, A. Outcome of Labor in Nullipara at term with Unengaged vertex. EKB Journal Management System, 2014; 10(2): 218-233. doi: 10.12816/0029159

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  XML PDF (302.76 K)
Document Type: Original Article
DOI: 10.12816/0029159
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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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