The ARRIVE trial (2018) compared elective induction of labour at 39 weeks to expectant management in low-risk nulliparous women. Its key finding was:
- A Elective induction at 39 weeks significantly increased caesarean delivery rate
- B Perinatal mortality was higher in the induction group
- C Elective induction at 39 weeks was associated with a lower caesarean delivery rate and no increase in adverse perinatal outcomes ✓
- D Neonatal ICU admission was significantly higher in the induction group
Correct answer: C. Elective induction at 39 weeks was associated with a lower caesarean delivery rate and no increase in adverse perinatal outcomes
Explanation
The ARRIVE trial (NEJM 2018, ~6000 low-risk nulliparous women) found that elective induction at 39 weeks, counter-intuitively, was associated with a lower caesarean delivery rate (18.6% vs 22.2%) compared to expectant management, and no significant difference in the composite perinatal outcome. This challenged the traditional teaching that induction increases caesarean risk and changed practice patterns significantly.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.