Background: A significant proportion of primigravidae presented with unengaged head at term and at the onset of labour. Though a substantial proportion of them deliver vaginally. The present study has been carried out to find out the relationship of fetal head palpable per abdomen with head station by per vaginal examination with the outcome of labour, nature of delivery and maternal and fetal well-being in primigravidae at term with or without onset of labour.

Methods: The study done at Vijayanagar Institute of Medical Sciences, Ballari between january 2020 and December 2020. Eighty full term primigravidae having cephalic presentation in early first stage of labour with intact membranes at different station of vertex were included in the study. The cases having major degree CPD and other Obstetric and medical complications of pregnancy were excluded.

Results: Among 80 cases, 55% (44) of cases delivered vaginally, 45% (36) had underwent caesarean section. This was statistically significant (p<0.01). Increase in average duration of first and second stages, total duration of labour, and incidence of instrumental and caesarean rates were higher with higher fetal station. There was a greater need for active medical and surgical intervention and there was no significant maternal and neonatal morbidity and mortality.

Conclusion: Primigravida with unengaged head at term gestation with or without onset of labour makes obstetrician apprehensive and suspicious about achieving vaginal delivery. But that should not be the sole indication for LSCS. Labour appeared to be dysfunctional in only small proportion of the patients with unengaged head. It is concluded that vaginal delivery is possible with watchful expectancy, proper monitoring and maintenance of partogram and timely intervention. Thus the operative interference can be reduced to the maximum extent and the art of labour and delivery can be preserved for the future obstetricians.