Maternal and neonatal outcome in primigravida with mobile head at ≥39 weeks of gestation

Authors

  • Sadhanadevi C. Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India
  • Sajini B. Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India
  • Acka Priya Varghese Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India
  • Divya Sara Raju Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India
  • Karishma Krishna Kurup Independent Public Health Consultant, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221016

Keywords:

Primigravida, Labour, Non engaged head

Abstract

Background: Primigravida with mobile head at ≥39 weeks of gestation are prone to the probability of caesarean section. With this study we aimed to identify the maternal and neonatal outcome of primigravida with mobile head at ≥39 weeks of gestation under the watchful expectancy and good conduct of labour.

Methods: A cross sectional study was conducted among primigravida with mobile head at ≥39 weeks admitted for delivery in the department of obstetrics and gynaecology, govt. medical college, Kottayam, Kerala, from February 2021 to September 2021. A sample size of 247 was identified considering 28% proportion of presentation with deflexed head, 95% confidence interval and 2% margin of error. A detailed history, physical examination and ultrasonography was performed.

Results: Of the 250 participants, the mean age of the study subjects was 24.97±3.93 and mean body mass index (BMI) was 23.72±4.78 kg/m2. The most common cause for mobile head was a deflexed head (35.2%). A lower segment caesarean section (LSCS) was conducted in 28.8% participants while vacuum assistance ad forceps assistance was required for 9.6% and 4.4% participants respectively. The most common indication for LSCSC being moderate to thick meconium-stained amniotic fluid (MSAF) 23% followed by 1st degree CPD failed trial in 17% cases. A significant association with maternal morbidity was observed in undiagnosed placenta previa (p=0.039) and vacuum-assisted deliveries (p=0.001). We observed that 3.6% of babies have meconium aspiration syndrome, and 8% of new born were admitted in intensive care for foetal distress.

Conclusions: Primigravida with mobile head at term during labour requires intense monitoring. Although the duration of labour appeared to be prolonged in a small proportion of patients with watchful expectancy and good conduct of labour and timely intervention, vaginal delivery is possible with minimal maternal and neonatal morbidity.

 

Author Biographies

Sadhanadevi C., Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India

Junior Resident

Department of Obstetrics & Gynaecology

Sajini B., Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India

Associate Professor

Department of Obstetrics & Gynaecology

Acka Priya Varghese, Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India

Additional Professor

Department of Obstetrics & Gynaecology

Divya Sara Raju, Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, India

Assistant Professor

Department of Obstetrics & Gynaecology

Karishma Krishna Kurup, Independent Public Health Consultant, Kerala, India

Independent Public health consultant

Kerala, India

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Published

2022-04-27

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Original Research Articles