The ARRIVE trial (A Randomized Trial of Induction Versus Expectant Management) demonstrated that elective induction of labour at 39 weeks in low-risk nulliparous women compared to expectant management resulted in:
- A Higher caesarean section rate in the induction group
- B Equivalent caesarean section rates with lower perinatal mortality in the induction group
- C Lower caesarean section rate in the induction group with no increase in adverse neonatal outcomes ✓
- D Higher instrumental delivery rates in the induction group but lower neonatal ICU admissions
Correct answer: C. Lower caesarean section rate in the induction group with no increase in adverse neonatal outcomes
Explanation
Contrary to the prior belief that induction increases caesarean rates, the ARRIVE trial (NEJM 2018) showed that elective induction at 39 weeks in low-risk nulliparous women actually resulted in a significantly lower caesarean section rate (18.6% vs 22.2%) compared to expectant management, with similar or improved neonatal outcomes including lower rates of respiratory support and neonatal ICU admission. This landmark trial has significantly changed obstetric practice and guidelines regarding elective induction at 39 weeks.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.