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Induction of labor at 39 weeks versus expectant management: a randomized
control trial
Abstract
Objective: To evaluate caesarean delivery rates in low-risk
women who were electively induced from 39 weeks 0 day to 39 weeks 6 days
in comparison to expectant management. Design: Prospective
randomized control trial Setting: The study setting of Obstetrics and
Gynaecology and Neonatology , All India Institute of Medical Sciences,
Bhubaneswar from 2021-2022 Population: All low-risk antenatal
women beyond 37 weeks of gestation visiting the outpatient department of
Obstetrics and Gynecology were recruited according to inclusion and
exclusion criteria. Methods: A prospective randomized
controlled trial at tertiary care centre from 2021 to 2022 included 156
low-risk antenatal women, divided into two groups of 78. One group
underwent elective induction at 39 weeks, while the other had expectant
management after 40 weeks. Main outcome measures: We compared
caesarean delivery rates and adverse perinatal outcomes.
Results: We randomly assigned 87 participants to each group and
analysed data from 78 in each at the conclusion of the study. Caesarean
delivery rates were 41% in the elective induction group and 51.3% in
the expectant management group, showing no statistically significant
difference (p = 0.199). A higher occurrence of meconium-stained amniotic
fluid was noted in the expectant management group (p = 0.032), while
other adverse perinatal outcomes showed no significant differences.
Author’s conclusions: It showed that elective induction of
labor reduces caesarean delivery rates and positively impacts the
overall pregnancy experience for mothers. It can be considered
advantageous for mother to opt for induction of labour rather than
waiting for it to commence naturally for better anticipation and
preparation of perinatal outcomes.