Which of the following is associated with an increased risk of cesarean delivery?

An unengaged presenting part during labor is associated with an increased risk of cesarean delivery. When the presenting part of the fetus, typically the head, has not descended into the pelvis, it indicates that the fetus may not be in an optimal position for delivery. This situation can lead to complications such as prolonged labor or failure to progress, prompting clinicians to consider cesarean delivery as a more reliable and safer option for both the mother and the baby.

In contrast, a normal fetal heart rate generally suggests that the fetus is tolerating labor well and is not in distress, which typically lowers the likelihood of a cesarean. Low maternal age and healthy maternal condition usually correlate with favorable outcomes during labor, further reducing the chances of needing a cesarean section. Therefore, the presence of an unengaged presenting part is a significant factor that increases the likelihood of a cesarean delivery due to potential complications in labor progression.