The ARRIVE trial (2018) demonstrated which finding about elective induction of labour at 39 weeks in low-risk nulliparous women compared to expectant management?

• A Induction at 39 weeks increased cesarean rate but improved neonatal outcomes with lower NICU admissions
• B Induction at 39 weeks significantly reduced the cesarean delivery rate and did not increase neonatal adverse outcomes ✓
• C No difference in cesarean rate or neonatal outcomes between induction and expectant management
• D Induction at 39 weeks increased maternal morbidity including PPH and wound complications

Explanation

The ARRIVE trial (A Randomized Trial of Induction Versus Expectant Management, NEJM 2018) randomized 6,106 low-risk nulliparous women to induction at 39+0–39+4 weeks vs expectant management. Contrary to expectation, induction at 39 weeks REDUCED cesarean delivery rate (18.6% vs 22.2%, P=0.001) and did not increase neonatal morbidity (NICU admissions were actually lower). The reduction in cesarean section is thought to be due to avoidance of macrosomia, meconium-stained liquor, and oligohydramnios that accrue with advancing gestational age in expectant management.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.