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Elective induction of labor at 39 weeks of gestation: a prospective randomized trial
1Department of Obstetrics and Gynecology, School of Medicine, Kitasato University, Kanagawa, Japan.
Objective:
To clarify the safety of elective induction of labor at 39 weeks of gestation.
Study Design:
Prospective randomized study.
Subjects And Methods:
Uncomplicated nulliparas (N = 194) were randomly assigned at 36 weeks of gestation. Labor was electively induced in 63 women at 39 weeks of gestation in the active management group (I group, N = 98). Spontaneous labor onset was expected with semi-weekly nonstress test (NST) and amniotic fluid index (AFI) by 42 weeks of gestation in the expectant group (E group, N = 96). Perinatal events were compared between the 2 groups.
Results:
A significantly higher incidence of meconium-stained amnios (19.4% vs 3.2%) and fetal resuscitation (16.7% vs 4.8%) was found in the E group than in the I group. Also, although a significantly higher incidence of epidural analgesia was noted in the I group (89%) than in the E group (54%) (labor onset > or = 39 weeks, N = 72), the duration of the 1st stage was shorter in I group and the duration of the 2nd stage was not significantly different. No other significant difference was noted between the 2 groups in terms of the rate of C-section, blood loss, incidence of pathological FHR, birth weight, Apgar score, umbilical arterial pH, or admission to NICU.
Conclusion:
Active management of labor at 39 weeks could be made as safely as expectant management with modified biophysical profile monitoring.
