Comparative Study of Obstetric and Neonatal Outcome between Spontaneous and Induced Labor In Gravid Women After 41 Completed Weeks Of Gestation

Objective: Both the mother and the infant are at increased risk of adverse outcomes when the pregnancy continues beyond term. The problems include induction of labor, caesarean section, prolonged labor, postpartum hemorrhage and traumatic birth. This study compared the results of elective induction versus expectant management of pregnancies at 41 completed weeks. Material & Method: In a randomized comparative trial 1136 women with 41 completed weeks of gestation, were randomly assigned to either immediate induction with dinoprostone gel or expectant management till 42 completed weeks. Primary outcome measure was caesarean section rate and secondary outcome measures were perinatal outcomes and maternal morbidities. Results: Cesarean section rate was significantly low in induction group when compared to expectant group (23.06% vs. 30.58%, p = 0.039, CMLE OR = 0.758). Maternal morbidities and labor events were comparable in both groups. There was no significant difference in neonatal outcomes between the two groups. Mean maternal hospital stay was significantly less in study group (p < 0.0001, 95% CI= -3.917 to -3.462) but NICU stay of neonates were similar in both groups. Conclusion: Induction of labor at 41 weeks of gestation for otherwise uncomplicated singleton pregnancies significantly reduce cesarean delivery rates without affecting perinatal outcomes.