EVALUATION OF ENGAGEMENT RATE IN NULLIPAROUS WOMEN AT THE BEGINNING OF ACTIVE PHASE OF LABOR AND EFFECT OF ENGAGEMENT ON DELIVERY ROUT

This study was done for evaluation of engagement rate in nulliparous women and it’s effect on delivery rout. 1322 nulliparas with term pregnancy at the beginning of active labor were studied and followed until delivery. 1132 of them were without engagement but there were 190 cases with engagement (14.4%) (All of the pregnant patients were singletone and with cephalic presentation). Maternal age and rupture of membrane didn’t have effect on engagement occurance whereas pelvic contraction was known as an important and effective factor on engagement occurance(P<0.005). Duration of second stage of labor in two groups was not statistically different, but the duration of first stage of labor in unengagement group wes more prolonged (P<0.005). Also fetal weight was an important factor on engagement occurance(P<0.05). Form 1132 patients without engagement, cesarean section were done in 108 cases. But in only 44 cases were because of progress failure and C.P.D In all cases with engagement vaginal delivery were occured. Therefore unoccurance of engagement alone cannot be a prognostic factor on delivery rout.