Induction of labor at 39 weeks versus expectant management: a randomized control trial

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.