In the ARRIVE trial (A Randomized Trial of Induction Versus Expectant Management), elective induction of labour at 39 weeks in low-risk nulliparous women compared to expectant management resulted in:

• A Significantly increased cesarean section rate in the induction group
• B Lower cesarean section rate and lower perinatal mortality/morbidity in the induction group ✓
• C No difference in cesarean section rate and no difference in neonatal outcomes
• D Significantly higher neonatal ICU admission rates in the induction group

Explanation

The ARRIVE trial (NEJM 2018) found that elective induction at 39 weeks did NOT increase cesarean delivery rates — in fact, the induction group had a slightly lower cesarean rate (18.6% vs 22.2%) compared to expectant management. Perinatal outcomes were similar, with a trend towards lower perinatal morbidity. This was a paradigm-shifting trial that challenged the traditional belief that elective induction increases cesarean risk. Options A, C, and D are inconsistent with the trial findings.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.