The ARRIVE trial (2018) randomized low-risk nulliparous women with uncomplicated pregnancies to elective induction at 39 weeks versus expectant management. The primary finding was:

• A Induction at 39 weeks significantly increased the cesarean delivery rate
• B Induction at 39 weeks had no effect on cesarean rate but increased neonatal morbidity
• C Induction at 39 weeks increased perinatal mortality
• D Induction at 39 weeks significantly reduced the cesarean delivery rate compared to expectant management ✓

Explanation

The ARRIVE trial (A Randomized trial of Induction Versus Expectant management, 2018) surprisingly found that elective induction of labor at 39 weeks in low-risk nulliparous women significantly reduced the cesarean delivery rate (18.6% vs 22.2%) compared to expectant management, without adverse perinatal outcomes. This counterintuitive result (induction reducing C-section risk) changed guidelines toward offering 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.