Outcomes of Primigravida with Engaged versus Unengaged Fetal Head at Term

Engagement of the fetal head within the pelvis is an important clinical indicator during pregnancy. Such evaluation guides obstetric decision-making and optimizes maternal and neonatal care. Objectives: To compare the frequency of outcomes in primigravida women with engaged and unengaged fetal heads at term. Methods: This prospective cohort study was carried out in the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar, from January 2025 to June 2025. A total of 126 primigravida women were recruited. Data were analyzed using SPSS version 22.0, and relative risk (RR) was calculated for both groups. Results: Among the 126 participants, the mean maternal age was 28.71 ± 6.80 years (range: 18–42 years). The mean birth weight in the engaged group was 3.07 kg. A significant association was observed between fetal head engagement and delivery mode. The unengaged group showed a markedly higher cesarean section rate (63%) compared with the engaged group (21%), with a relative risk of 2.93. Conclusions: Primigravida women with unengaged fetal heads at term had a significantly greater likelihood of cesarean delivery compared with those with engaged heads.