Engagement of Fetal Head as a Predictor of a Successful Vaginal Delivery in Primigravidas Presented in Early Labor
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 226
- 试验地点
- 1
- 主要终点
- Incidence of cesarean section in primigravidas with unengaged fetal head in compare to primigavidas with engaged fetal head .
研究概览
简要总结
In primigravida, Delayed engagement of fetal head has been theorized that it is more likely in women with a possible cephalo-pelvic disproportion, so far they are associated with higher risk of cervical dystocia, which led to increased rate of caesarean section.
详细描述
This study will involve total 226 of " 113 primigravida patients with engaged head and 113 primigravida patients with unengaged head .
while assessment of fetal head station, status of membrane should be evaluated and noted.
Engagement will be assessed by vaginal examination as described by Müller in 1868 , assumes that when the leading edge of the vertex is felt at the level of the ischial spines, the biparietal diameter will have just passed through the pelvic brim. The leading edge of the vertex at the level of the ischial spines is designated as being at station 0. If the leading edge is 1 cm below the level of the spines, this is referred to as station +1. Usually, a head on the pelvic floor is at station +4 or +5.
Uengaged head is still 2 cm above the level of the spines is at station -2, and so on.
The aim of this study will be to determine if primigravida patients with unengaged head after spontaneous onset of labor are at increased risk of cesarean section.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Term pregnancy (37-42) weeks.
- •Expected foetal birth weight of 2.5-4.0 kg on USG at term.
- •Singleton live pregnancy.
- •Cephalic presentation.
- •Cervical dilatation of =/< 4cms.
- •Reactive CTG at onset of labour.
- •Confirmation of ROM by Direct visualization or Fern test.
排除标准
- •Contracted pelvis.
- •Previous uterine surgery " upper segment ".
- •Pregnancy complications like antepartum haemorrhage, pregnancy induced hypertension, gestational diabetes mellitus, IUGR.
- •Fetal congenital anomalies.
- •Abnormal or non reassuring fetal CTG at term or at onset of labour.
结局指标
主要结局
Incidence of cesarean section in primigravidas with unengaged fetal head in compare to primigavidas with engaged fetal head .
时间窗: 24 hours
section in primigravidas with unengaged fetal head in compare to primigavidas with engaged fetal head .
次要结局
- Duration of labor progress in patients with unengaged(24 Hours)
研究者
mohamed abosena
Principal Investigator
Ain Shams University