Unengaged foetal head in Pakistani primigravida: frequency and outcome.

The frequency of engagement of foetal head in the maternal pelvis at 36 weeks of pregnancy (N = 100) and in early labour (N = 246) were studied in Pakistani primigravida. The head was engaged in 2 (2%) at 36 weeks. In labour only 50 (20.3%) patients had head engaged. There was no difference in the mean age and mean height of the patients with head engaged and those with head unengaged. The duration of labour was significantly higher (p value = 0.02) in the ‘unengaged’ groups and the rate of operative delivery greater. However, 81% of patients with head not engaged delivered vaginally without increased foetal morbidity. The mean birth weights, head circumference and Apgar score were not different. A plea for conservative attitude in Pakistani primigravida with unengaged head in early labour is made.