الفهرس 
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Abstract
Engagement has been defined as the passage of the large transverse diameter of fetal head (biparietal diameter) through pelvic inlet. Clinically it has been defined when fetal head has been felt at the level of ischial spines and is referred to as station zero. Any station above this level has been given lower number -1,-2,-3,-4 and -5.
The present study was conducted on 100 primigravidas with unengaged fetal head presented at term in active labour. Any solid indication for cesarean section whether in the mother or the fetus was excluded. Those cases were given a full trial of labour and the progress of each was recorded on a partogram. Mode of delivery, duration of labour (first and second stages), weight of the new born and Apgar scores were all recorded. Maternal morbidity and mortality were also recorded.
Epidural anesthesia was given to patients on demand and its effect on mode of delivery and duration of first and second stages of labour was reported.
After collecting the results from our data sheet and analyzing them, we found that most of patients included in the study delivered vaginally (74%) and 26% delivered by cesarean section. The most common indication for cesarean section was arrest disorders.
Primigravida with unengaged fetal head at onset of labour, although at risk for C.S., most of them delivered vaginally if they were given a full trial of labour and watched carefully.
Length of first and second stages of labour is prolonged slightly in those patients. The need for labour augmentation is increased in those patients. Apgar scores at 1 and 5 minutes are decreased in newborn of those primigravidas.
Use of epidural anesthesia didn’t affect rate of C.S. although it lengthen duration of first and second stages of labour.