Outcome of High Foetal Station in Primigravida With Vertex Presentation at Term - A Clinical Study in a Tertiary Care Center


Rucha Dashrathi
Manasi Kathaley


Introduction: There is an uncertain relationship between foetal station and mode of delivery. The rise in the rates of caesarean section in unengaged head in primigravida is due to the reason that high foetal station which is considered as a threat to normal progress of labor and so immediately considered as an indication to early caesarean section. A vigilant attitude and timely intervention can help in decreasing chances of C-section and help such cases deliver vaginally. Aims and Objectives: To study the outcome of unengaged head in full term primigravida in labor. 1. To evaluate the causes of unengaged head and analyse progress of labour. 2. To assess maternal and foetal outcome. Material and Methods: 124 Primigravidae at term with unengaged foetal head in labor were undertaken in the study after they met eligibility criteria. After history taking and clinical examination, course of their labor was monitored partographically to study the maternal and neonatal outcome. Results: Out of 124 patients, 84 (67.74%) patients had vaginal delivery while in 40 (32.26%) Lower Segment Caesarean Section (LSCS) was performed. Out of 84 vaginal deliveries, 64 patients had full term normal deliveries while 20 patients needed assisted instrumental deliveries. Thus, out of 124 deliveries, 64 (51.61%) had normal vaginal deliveries, 20 (16.12%) instrumental deliveries and 40 (32.25%) Caesarean sections. Conclusion: We can imply that primigravida at term with high foetal station with spontaneous onset of labor are not all for immediate caesarean section. Watchful expectancy, vigilant intrapartum partographic monitoring can result into normal vaginal delivery with minimal maternal and foetal complications.


How to Cite
Dashrathi, R., & Kathaley, M. (2020). Outcome of High Foetal Station in Primigravida With Vertex Presentation at Term - A Clinical Study in a Tertiary Care Center. MVP Journal of Medical Sciences, 161–169. https://doi.org/10.18311/mvpjms/2020/v7i2/24639


  1. D.C. Dutta. DC Dutta's textbook of obstetrics. Seventh ed. New Delhi, India: Jaypee Brother's Medical Publishers Pvt. Ltd.; 2013.
  2. Dwight JR, John ES. Normal labour, delivery, newborn care and puerperium. In: Danforths Obstetrics and Gynecology. 9th edition. 530 Wallnet street Philadelphia: Lippincott Williams & Willikans 2003: 35–7.
  3. Debby A, Rotmenseh S, Girtler O, Sadan O, Golan A, Glezerman M. Clinical significance of the floating head in nulliparous women in labour. J Reprod Med 2003; 48 (1): 37–40.
  4. Ambwani B. Primigravidas with Floating Head at Term or Onset of Labor. The Internet Journal of Gynecology and Obstetrics. 2004; 3(1): 1–4. https://doi.org/10.5580/2450
  5. Abbaspur Z, Afshari P, Safzezari F. The Correlation between Engagement Time of Foetal Head in Early Active Phase and Delivery Outcome of Primigravida Women. J. Rafsanjan Univ. Med. Sci. 2005. 2018; 4(1): 2.
  6. Mahajan N, Mustafa S, Tabassum S, Fareed P. Outcome of high fetal station in Primi-Gravida at term in labour. Int J Reprod Contracept Obstet Gynecol. 2016; 873–877. https:// doi.org/10.18203/2320-1770.ijrcog20160602
  7. Khurshid N, Sadiq F. Management of Primi-Gravida with unengaged head at term. Pak. J. Med. Health Sci.. 2012; 6(1): 36–38.
  8. Mahendra. G P. Clinical Study of Un-engaged head of Primigravida at Term in Labor. International Journal of Recent Trends in Science and Technology 2014; 10(2):345- 349.
  9. Sudhir S, Mishra S. The outcome of labour in primigravida with term gestation and unengaged head at onset of labour. Indian J Obstet Gynecol Res. 2016; 3(3): 199. https://doi. org/10.5958/2394-2754.2016.00045.X
  10. Unnisa S, Poornima MS. Unengaged head at term in primigravida: does it affect the chance of having a normal delivery? Int J Reprod Contracept Obstet Gynecol. 2019; 8: 1616–9. https://doi.org/10.18203/2320-1770. ijrcog20191228
  11. ArunaRekha N, Vijayasarathy K, Ashwani N et.al. Fetal station at onset of labor depicting mode of delivery and fetal outcome: hospital based observational study. Galore International Journal of Health Sciences & Research. 2018; 3(3): 47–51.
  12. Chaudhary S, Farrukh R, Dar A, Humayun S.; Outcome of labour in nullipara at term with unengaged vertex.; J Ayub Med Coll Abbottabad. Jul-Sep 2009; 21(3): 131–4.
  13. Pahwa S, Kaur A, Nagpal M. Obstetric outcome of floating head in primigravida at term. Int J Reprod Contracept Obstet Gynecol 2018; 7: 242–7. https://doi.org/10.18203/2320- 1770.ijrcog20175854
  14. Kang M, Kaur D. Effect of fatal station at the onset of labour on cervimetric progress in primigravida. J Obstet Gynaecol India 2000; 50(3): 42–4.
  15. Shivamurthy HM, Asaranna D, Giridhar SA, Jannu P, Jassawalla N, Himgire JR. Comparative study of labor course in primigravida with unengaged head in active labour, with those having engaged head. Medica Innovatica. 2014; 3(2): 84–9.
  16. Noura, S. E l Nassery, M.D.; Eman A. E l Kattan, M.D., Unengaged Head in Primigravidas, Will it affect the Chance of Having a Vaginal Birth? Med. J. Cairo Univ. VOL 81, No. 1, March 2013: 221–225.