The ARRIVE trial (2018, NEJM) randomized nulliparous low-risk women at 39 weeks to elective induction versus expectant management. The most clinically important finding of this trial was:

• A Elective induction at 39 weeks had equivalent cesarean rate but reduced perinatal morbidity
• B Elective induction at 39 weeks significantly reduced cesarean delivery rate compared to expectant management ✓
• C Expectant management significantly reduced cesarean rate compared to elective induction
• D Elective induction increased NICU admissions despite reducing cesarean rate

Explanation

The ARRIVE trial (Grobman et al., NEJM 2018) was a landmark trial showing that elective induction at 39 weeks in low-risk nulliparous women was associated with a significantly LOWER cesarean delivery rate (18.6% vs 22.2%, P=0.0002) compared to expectant management. This contradicted prior observational data suggesting induction increases cesarean risk. Perinatal morbidity was not significantly different. This finding changed practice, supporting offering elective induction at 39 weeks to nulliparous women as it does not increase cesarean risk and may reduce it.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.