The ARRIVE trial (A Randomized Trial of Induction versus Expectant Management) demonstrated that elective induction of labor at 39 weeks in low-risk nulliparas compared to expectant management resulted in:
- A Higher cesarean delivery rate in the induction group
- B Similar cesarean rates but higher neonatal ICU admissions in the induction group
- C Lower cesarean delivery rate and lower perinatal composite morbidity in the induction group ✓
- D Reduced maternal mortality but no difference in perinatal outcomes
Correct answer: C. Lower cesarean delivery rate and lower perinatal composite morbidity in the induction group
Explanation
The ARRIVE trial (Grobman et al., NEJM 2018) challenged the traditional belief that routine induction increases cesarean risk. It found that elective induction at 39 weeks in low-risk nulliparas actually led to a significantly LOWER cesarean delivery rate (18.6% vs 22.2%) and lower rates of perinatal morbidity (hypertension, intubation) compared to expectant management. This paradigm-shifting result changed clinical practice in many centers and updated ACOG guidance on elective induction.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.